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SOCIAL  DIAGNOSIS 


BY 

MARY„E.  RICHMOND 

DIRECTOR  CHARITY  ORGANIZATION  DEPARTMENT 
RUSSELL  SAGE  FOUNDATION 
AUTHOR  OF 

“THE  GOOD  NEIGHBOR,”  ETC. 


NEW  YORK 

RUSSELL  SAGE  FOUNDATION 

1917 


1 


Copyright,  1917,  by 
The  Russell  Sage  Foundation 


WM  •  F.  FELL  CO  •  PRINTERS 
PHILADELPHIA 
♦  ♦  * 


1? 


I 

«  ^^5-5 


TO 

ZILPHA  DREW  SMITH 

WHOSE  STEADY  FAITH  IN  THE  POSSIBILITIES 
OF  SOCIAL  CASE  WORK  HAS  BEEN  THE  INSPIRA¬ 
TION  OF  THIS  BOOK  AND  OF  ITS  AUTHOR 


T!/99j15 


l 


One  of  the  most  striking  facts  with  regard  to  the  conscious  life  of 
any  human  being  is  that  it  is  interwoven  with  the  lives  of  others. 
It  is  in  each  man  s  social  relations  that  his  mental  history  is 
mainly  written,  and  it  is  in  his  social  relations  likewise  that  the 
causes  of  the  disorders  that  threaten  his  happiness  and  his  effec¬ 
tiveness  and  the  means  for  securing  his  recovery  are  to  be  mainly 
sought. 

—DR.  JAMES  JACKSON  PUTNAM 

No  matter  how  mean  or  hideous  a  man  s  life  is,  the  first  thing  is 
to  understand  him;  to  make  out  just  how  it  is  that  our  common 
human  nature  has  come  to  work  out  in  this  way.  This  method 
calls  for  patience,  insight,  firmness,  and  confidence  in  men, 
leaving  little  room  for  the  denunciatory  egotism  of  a  certain  kind 
of  reformers.  It  is  more  and  more  coming  to  be  used  in  dealing 
with  intemperance,  crime,  greed,  and  in  fact  all  those  matters 
in  which  we  try  to  make  ourselves  and  our  neighbors  better. 

—CHARLES  HORTON  COOLEY 

Only  the  sham  knows  everything;  the  trained  man  understands 
how  little  the  mind  of  any  individual  may  grasp,  and  how  many 
must  co-operate  in  order  to  explain  the  very  simplest  things. 


— HANS  GROSS 


PREFACE 


FIFTEEN  years  ago,  I  began  to  take  notes,  gather  illustra¬ 
tions,  and  even  draft  a  few  chapters  for  a  book  on  Social 
Work  in  Families.  In  it  I  hoped  to  pass  on  to  the  younger 
people  coming  into  the  charity  organization  field  an  explanation 
of  the  methods  that  their  seniors  had  found  useful.  It  soon  be¬ 
came  apparent,  however,  that  no  methods  or  aims  were  peculiarly 
and  solely  adapted  to  the  treatment  of  the  families  that  found 
their  way  to  a  charity  organization  society;  that,  in  essentials, 
the  methods  and  aims  of  social  case  work  were  or  should  be  the 
same  in  every  type  of  service,  whether  the  subject  was  a  homeless 
paralytic,  the  neglected  boy  of  drunken  parents,  or  the  widowed 
mother  of  small  children.  Some  procedures,  of  course,  were 
peculiar  to  one  group  of  cases  and  some  to  another,  according  to 
the  special  social  disability  under  treatment.  But  the  things 
that  most  needed  to  be  said  about  case  work  were  the  things 
that  were  common  to  all.  The  division  of  social  work  into  de¬ 
partments  and  specialties  was  both  a  convenience  and  a  neces¬ 
sity;  fundamental  resemblances  remained,  however. 

With  other  practitioners — with  physicians  and  lawyers,  for  ex¬ 
ample — there  was  always  a  basis  of  knowledge  held  in  common. 
If  a  neurologist  had  occasion  to  confer  with  a  surgeon,  each  could 
assume  in  the  other  a  mastery  of  the  elements  of  a  whole  group 
of  basic  sciences  and  of  the  formulated  and  transmitted  experience 
of  his  own  guild  besides.  But  what  common  knowledge  could 
social  workers  assume  in  like  case?  This  was  my  query  of  fifteen 
years  ago.  It  seemed  to  me  then,  and  it  is  still  my  opinion,  that 
the  elements  of  social  diagnosis,  if  formulated,  should  constitute 
a  part  of  the  ground  which  all  social  case  workers  could  occupy 
in  common,  and  that  it  should  become  possible  in  time  to  take  for 
granted,  in  every  social  practitioner,  a  knowledge  and  mastery 
of  those  elements,  and  of  the  modifications  in  them  which  each 
decade  of  practice  would  surely  bring. 


PREFACE 


Th  is  narrowed  my  proposed  topic  to  the  beginning  processes  of 
case  work,  but  at  the  same  time  widened  it  enormously  in  demand¬ 
ing  for  its  treatment  an  experience  of  all  the  various  types  of  such 
work.  As  the  executive  head,  in  those  days,  of  a  large  family 
agency,  1  had  little  time  for  study,  so  the  task  was  set  aside  for 
nearly  nine  years. 

More  than  six  years  ago,  however,  after  I  had  become  a  member 
of  the  staff  of  the  Russell  Sage  Foundation,  it  was  again  taken  up. 

Meanwhile,  the  wider  usefulness  of  social  evidence,  social  diag¬ 
nosis,  and  social  treatment,  both  in  their  own  special  field  and  in 
the  other  professions,  even  when  these  latter  dealt  with  people 
who  were  neither  dependent  nor  delinquent,  had  begun  to  dawn 
upon  me.  It  was  evident  that  social  case  work  could  supplement 
the  work  of  justice,  of  healing,  and  of  teaching.  Groups  of  workers 
in  some  of  our  American  cities,  moreover,  were  doing  notable 
things  in  the  regular  social  agencies;  they  were  developing  quietly 
a  diagnostic  skill  in  dealing  with  the  difficulties  of  human  beings 
which  should  be  given  ample  opportunity,  especially  in  its  forma¬ 
tive  period,  to  grow  to  the  full  stature  of  social  technique,  un¬ 
trammeled  by  long  established  professional  traditions,  whether  of 
courts,  hospitals,  or  schools. 

I  turned  to  this  task  in  the  winter  of  1910-11  for  the  second 
time,  therefore,  with  a  quite  different  outlook  from  that  of  earlier 
days  and  with  the  determination  to  push  my  inquiries  as  far  be¬ 
yond  the  limits  of  my  own  personal  experience  as  possible.  Mr. 
Francis  H.  McLean,  who  was  my  colleague  in  the  Foundation  at 
the  time  of  this  second  beginning  and  who  has  rendered  invaluable 
assistance  throughout  the  undertaking,  had  already  invited  a 
group  of  social  case  workers  (most  of  them  but  not  all  connected 
with  charity  organization  societies)  to  prepare  short  papers  de¬ 
scribing  informally  their  methods  and  experiences  in  taking  the 
steps  which,  in  their  work,  preceded  the  development  of  a  plan  of 
treatment.  This  group  was  added  to  later,  and  some  of  their 
papers — on  such  subjects,  for  instance,  as  present  neighborhood 
sources  of  information,  relations  with  employers  in  the  study  of  a 
work  record,  methods  of  conducting  a  first  interview,  etc. — were 
privately  printed  and  given  a  limited  circulation  among  their 
fellow  workers  in  charity  organization.  This  was  done  partly  for 

6 


PREFACE 


the  purpose  of  getting  the  benefit  of  criticisms.  The  papers  were 
too  experimental  for  publication.  They  contained  passages  of 
great  value,  however,  of  which  free  use  has  been  made,  with  credit 
given,  in  Part  1 1  of  this  book. 

The  next  step  was  to  engage  two  case  workers  of  experience — 
one  in  family  and  one  in  medical-social  work — to  study  original 
case  records  for  a  year.  Their  case  reading  was  done  in  five  dif¬ 
ferent  cities.  No  attempt  was  made  to  arrive  at  an  average  of 
the  case  work  in  these  cities.  On  the  contrary,  our  aim  was  to 
bring  to  light  the  best  social  work  practice  that  could  be  found, 
provided  it  was  actually  in  use  and  not  altogether  exceptional 
in  character.  In  addition  these  case  readers  held  many  inter¬ 
views  with  case  workers,  all  of  which  were  carefully  reported. 
As  my  own  experience  had  been  so  largely  in  the  charity  organiza¬ 
tion  field,  especial  pains  was  taken  to  center  most  of  this  case 
reading  and  interviewing  in  the  child-helping  and  the  medical- 
social  agencies.  A  large  part  of  the  illustrative  material  used  so 
freely  in  Part  1 1  is  drawn  from  the  much  larger  stock  of  case  notes 
and  of  reports  of  interviews  prepared  by  these  two  case  readers, 
though  use  has  also  been  made  of  notes  from  my  own  case  reading 
and  of  the  field  memoranda  of  my  colleagues  in  the  Charity  Organ¬ 
ization  Department  of  the  Foundation. 

As  this  Department  had  been  interested  from  the  time  of  its 
organization  in  the  teaching  of  case  work  in  the  various  schools 
for  social  workers,  it  began  to  edit  a  group  of  original  records,  most 
of  them  current  cases,  to  be  used  in  the  class  room.  These  were 
printed  in  full  with  all  their  sins  upon  their  heads  (bad  work  is 
almost  as  instructive  as  good)  and  were  used  in  class  conferences 
by  a  small,  accredited  group  of  teachers  of  case  work.  Criticisms 
and  comments  based  upon  certain  of  these  records  were  also 
gathered  from  a  number  of  specialists.  As  noted  elsewhere,  the 
experiment  of  printing  the  records  of  cases  could  not  be  a  public 
one,  because  their  subjects  were  real  people  whose  confidences  had 
to  be  respected.  Even  when  all  names  had  been  changed,  there 
were  few  things  more  identifiable,  we  found,  than  a  full  social  case 
record.  The  experiment,  limited  though  it  had  to  be,  has  brought 
to  light  many  valuable  suggestions  which  are  used  in  these  pages. 

For  the  most  part  the  subject  of  social  diagnosis  defies  statistical 

7 


PREFACE 


treatment,  though  as  a  means  of  getting  started  and  to  arrive  at 
a  rough  quantitative  measure  of  the  relative  frequency  with  which 
the  various  outside  sources  of  information  and  co-operation  were 
consulted,  a  brief  statistical  study  was  made.  Fifty-six  social 
agencies  engaged  in  a  number  of  different  forms  of  social  case  work 
in  three  cities  were  persuaded  to  let  us  list  the  outside  sources  con¬ 
sulted  by  each  in  fifty  cases.  The  results  of  this  study  are  given 
in  Part  1 1  and  in  one  of  the  Appendices. 

One  of  the  minor  methods  of  study  adopted  was  to  correspond 
with  or  interview  social  case  workers  who  had  changed  from  one 
type  of  case  work  to  another — from  work  with  families  to  child 
protection,  from  settlement  work  to  probation  or  medical-social 
service — in  order  to  learn  the  changes  of  method  and  the  shiftings 
of  emphasis  made  necessary  by  their  change  of  task. 

The  foregoing  methods  supplied  the  data  for  Part  1 1 ;  and  the 
sifting  of  these  data  and  the  interpretation  of  what  was  significant 
in  them  have  been  the  work  of  such  portions  of  several  years  as 
could  be  spared  for  the  task.  The  errors  that  were  found  have 
been  frankly  commented  upon  in  this  book.  Since  methods  in 
case  work  are  rapidly  improving,  these  may  now  belong  to  the 
past  in  the  particular  places  in  which  we  found  them.  Never¬ 
theless  there  is  always  a  chance  that  they  are  surviving  somewhere 
else. 

For  the  variations  in  the  processes  leading  to  diagnosis,  still 
another  method  of  gathering  data  was  tried.  How  could  these 
variations,  many  of  them  made  necessary  by  the  different  types  of 
social  disability,  be  indicated  comprehensively  enough  and  com¬ 
pactly  enough  to  be  of  daily  service  for  reference?  The  plan  was 
hit  upon  of  gathering  in  from  many  specialists  suggestions  for  a 
series  of  type  questionnaires — not  to  consist  of  questions  to  be 
asked  the  case  worker’s  client,  not  schedules  to  be  filled  out,  but 
lists  of  suggestive  queries  which,  at  some  time  in  his  inquiry,  the 
case  worker  might  find  it  worth  while  to  ask  of  himself.  Such  a 
battery  of  interrogations  as  is  presented  in  Part  III  is  sure  to  be 
misunderstood  by  somebody;  it  is  confessedly  a  clumsy  device, 
but  no  other  way  has  occurred  to  me  or  my  colleagues  of  giving 
the  case  worker,  in  small  compass,  a  bird’s-eye  view  of  the  possible 
implications  of  a  given  disability.  It  will  be  seen  that  some 

8 


1 

PREFACE 

questionnaires  were  prepared  by  one  hand,  some  by  another;  while 
still  others  have  been  made  by  members  of  our  departmental  staff 
in  consultation  with  case  workers.  These  latter  in  particular  must 
be  understood  to  be  experimental  in  their  present  form;  they  will 
have  to  be  revised  from  time  to  time  as  it  is  possible  to  get 
further  light  from  specialists  who  understand  not  only  their  own 
specialty  but  the  needs  of  social  workers. 

The  most  difficult  of  all  my  problems  has  been  to  make  a  pre¬ 
sentation  of  the  subject  of  evidence  in  Part  I  which  would  be  of 
practical  value  to  the  case  worker.  He  is  handling  evidence  all 
the  time.  How  can  he  learn  to  handle  it  in  such  a  way  as  to  aid 
him  in  achieving  a  truly  social  result?  When  Professor  Hans 
Gross  was  preparing  his  large  handbook  for  the  investigating 
officers  of  European  law  courts,1  he  planned  at  first  to  have  each 
part  written  by  a  specialist — by  a  physician,  an  armorer,  a  photog¬ 
rapher,  etc.  But  these  specialists  could  not,  he  finally  decided, 
meet  the  needs  of  the  investigating  officers  by  sufficiently  keeping 
in  view  their  aims  and  the  conditions  of  their  work.  Therefore, 
though  Gross  reflected  that  the  various  chapters  of  his  book 
“would  have  been  set  out  in  a  more  scientific  manner”  by  such  a 
plan,  he  was  constrained  for  his  purpose  to  adopt  a  less  ambitious 
one.  With  far  less  equipment  than  Gross,  who  had  an  encyclo¬ 
pedic  mind,  this  is  what  I  have  had  to  do,  and  I  could  not  have 
done  it  without  very  generous  help  in  criticism  and  revision  from 
those  who  knew  law  and  history,  psychology  and  logic,  as  I  did  not. 

Both  Professor  J.  H.  Wigmore,  Dean  of  Northwestern  Uni¬ 
versity  Law  School,  and  Professor  Lucy  Salmon,  head  of  the  de¬ 
partment  of  history  at  Vassar,  have  been  kind  enough  to  make 
suggestions  regarding  individual  chapters.  Special  acknowledg¬ 
ment  too  should  be  made  of  the  invaluable  service  rendered  by 
Mrs.  Ada  Eliot  Sheffield  of  Cambridge,  Massachusetts,  who  has 
not  only  read  and  criticised  the  larger  part  of  my  manuscript, 
but  in  connection  with  Part  I  has  gathered  some  of  the  illustrative 
material  and  has  given  the  whole  part  a  thorough  revision,  amount¬ 
ing  in  at  least  two  of  its  chapters  to  collaboration.  Mrs.  Sheffield’s 

Criminal  Investigation.  A  practical  handbook  for  magistrates,  police  officers, 
and  lawyers.  Translated  by  J.  Adam  and  J.  C.  Adam.  Madras,  A.  Krishnama- 
chari,  1906. 


9 


PREFACE 


thorough  knowledge  of  social  case  work  under  both  state  and  pri¬ 
vate  auspices  has  made  her  assistance  doubly  valuable. 

Acknowledgment  cannot  be  made  individually  to  the  several 
hundred  case  workers  who  have  answered  letters,  examined  ques¬ 
tionnaires,  lent  case  records,  and  helped  me  in  a  dozen  other  ways. 
They  lead  lives  filled  with  demands  and  are  accustomed  to  spend 
themselves  unsparingly,  so  that  each  and  all  met  this  one  more  de¬ 
mand  with  prompt  cheerfulness.  Mention  can  be  made,  however, 
of  those  who  have  been  associated  with  me  in  the  Russell  Sage 
Foundation  in  gathering  data  for  this  book  or  in  correcting  its 
first  draft.  Mr.  Francis  H.  McLean  should  head  this  list,  and  the 
two  case  readers,  Mrs.  Hilbert  F.  Day  and  Mrs.  H.  S.  Amsden. 
1  am  also  indebted  to  Miss  Margaret  F.  Byington,  Miss  Caroline 
L.  Bedford,  and  to  my  present  associate,  Miss  Mary  B.  Sayles. 
Valued  help  was  rendered  at  one  stage  of  gathering  material  by  the 
departments  of  social  investigation  of  the  Chicago  School  of  Civics 
and  Philanthropy  and  of  the  Boston  School  for  Social  Workers. 

In  1914,  as  Kennedy  lecturer  of  the  New  York  School  of  Philan¬ 
thropy,  I  used  portions  of  these  data  that  I  had  then  gathered  in  a 
course  of  six  lectures.  I  had  to  disclaim  at  that  time  and  do  now 
any  idea  that  one  who  “crams”  technical  discussions  of  method 
becomes  thereby  an  efficient  practitioner.  Not  only  is  practice 
under  leadership  needed  in  addition  to  book  knowledge,  but  an 
attractive  and  forceful  personality  is  an  indispensable  factor. 
The  method  that  ignores  or  hampers  the  individuality  of  the 
worker  stands  condemned  not  only  in  social  work  but  in  teach¬ 
ing,  in  the  ministry,  in  art,  and  in  every  form  of  creative  en¬ 
deavor.  Yet  in  none  of  these  disciplines  have  practitioners  refused 
to  profit  by  process  studies  in  their  own  field,  in  none  have  they 
found  ordered  knowledge  the  enemy  of  inspiration.  Phillips 
Brooks  once  said  of  a  certain  type  of  minister,  “The  more  the 
empty  head  glows  and  burns,  the  more  hollow  and  thin  and  dry  it 
becomes.”  Any  social  worker  who  has  had  to  gather  up  the 
pieces  after  a  supposed  original  genius  who  had  dispensed  with 
precedent  and  technique  would  be  at  a  loss  to  say  which  leaves 
behind  him  the  more  completely  burnt  out  territory — the  purely 
inspirational  worker  or  the  one  who  leans  too  heavily  upon  rules 
and  formulae. 


10 


f 


PREFACE 

For  the  benefit  of  those  who  find  certain  of  the  bibliographical 
references  in  the  footnotes  too  scant,  it  should  be  explained  that 
these  have  been  deliberately  cut  to  the  briefest  possible  form 
wherever  the  books  or  articles  referred  to,  because  they  bore  di¬ 
rectly  upon  my  theme,  have  been  included  in  the  Bibliography  at 
the  end  of  the  volume.  Fuller  details  will  always  be  found  there. 
It  should  be  added  that,  in  the  illustrations  taken  from  actual  cases 
which  are  given  throughout  the  volume,  names  have  in  all  in¬ 
stances  been  changed. 

Finally,  no  one  will  accuse  me  of  disloyalty  to  the  group  with 
which  I  have  been  identified  so  long  because  I  have  not  hesitated 
to  point  out  its  present  weaknesses  on  the  diagnostic  side.  My 
task  was  undertaken  because  there  were  weaknesses,  but  it  could 
not  have  been  pushed  forward  if  many  social  case  workers  had  not 
been  doing  effective  and  original  work,  though  often  under  great 
difficulties.  If,  after  examining  these  pages,  the  harassed  and  over¬ 
burdened  practitioner  is  tempted  to  think  their  counsels  im¬ 
practicable  under  the  conditions  which  necessarily  limit  his  daily 
task,  let  him  ask  himself  whether  “ necessarily”  does  not  beg  the 
question,  and  whether  some  of  those  conditions  should  not  and 
cannot  be  changed.  Then,  if  he  is  still  sure  that  I  am  at  fault, 
or  if  he  finds  other  errors,  whether  of  omission  or  of  commission, 
let  him  write  and  tell  me  so.  I  have  good  reason  for  inviting 
criticism.  No  one  knows  better  than  I  how  tentative  this  discus¬ 
sion  is.  In  the  remote  chance  of  there  being  another  edition  of 
this  book,  however,  I  should  like  to  make  it  more  useful  than, 
with  my  utmost  endeavors,  I  am  now  able  to. 

Mary  E.  Richmond. 

New  York,  April,  1917. 


I 

I  I 


1 


|L 


fife* 


table  of  contents 

p4rt  i 

SOCIAL  EVIDENCE 


Beginnings 


Ch/ 


pter  I 


PAGE 

25 

I.  The  Economic  and  the  More  Comprehensive  Approach  28 

i*  phe  Forerunners,  28.  2.  Charity  Organization  Beginnings, 

3.  First  Attempts  to  Establish  Standards,  30. 

II.  The  Approach  by  Way  of  child  Study 
III.  The  Medical  Approach 


Chapter  \\ 

The  Nature  and  Uses  of  Social  Evidence 
I.  Social  Evidence  Differentiated 
II.  The  Wider  Use  of  Social  Evidence 
Summary 

Chapter  HI 

Definitions  Bearing  upon  Evidence 

I.  Certain  Terms  Frequently  Used 

1.  Diagnosis,  51.  2.  Witrte$ses,  52.  3.  Fact,  53.  4.  Evidence,  55. 

II.  Types  of  Evidence 

Z.  Testimonial  Evidence,  57.  3.  Circum- 


1.  Real  Evidence,  56. 
stantial  Evidence,  59. 


Summary 

Chapter  IV 

Testimonial  Evidence 

I .  The  Competence  of  the  Witness 

1.  Attention,  66.  2.  Memory,  68.  3.  Suggestibility,  69.  4.  Lead¬ 

ing  Questions,  71. 

1 1 .  The  Bias  of  the  Witness 

1.  Racial  or  National,  73.  2.  Environmental,  75.  3.  The  Bias  of 

Self-interest,  76. 

Summary 


33 

34 


V 


38 

38 

43 

5° 

5i 

56 

62 

64 

65 

73 

79 


13 


TABLE  OF  CONTENTS 


Chapter  V 

Inferences 

I.  How  Inference  Is  M&de 
II.  How  Inference  Is  Corroborated 

III.  The  Risks  Involved  in  Thinking 

i.  Mistaken  General  Rule,  88.  2-  Mistaken  Particular  Case,  90. 
3.  Mistaken  Analogy,  91.  4.  Mista^en  Causal  Relation,  92. 

IV.  The  Risks  Arising  from  the  1  hinker’s  State  of  Mind 

1.  Predispositions,  94.  2.  AssumP^ons»  95*  3 •  Some  Other  Habits 

of  Thought,  96. 

Summary 

PARI-  11 

THE  PROCESSES  LEAPING  TO  DIAGNOSIS 

Chapter  VI 

The  First  Interview 

I.  Modifying  Circumstances 

1.  The  Nature  of  the;  Task,  i(4-  2.  The  Origin  of  the  Application, 

106.  3.  The  Place  of  the  Ir  ter  view,  106.  4.  The  Recorded  Expe¬ 

rience  Available  as  a  Starting  P°int>  1 10- 

II.  Scope 
III.  Method 

1.  The  Approach,  115.  2.  Clues  and  Questions,  120.  3.  Taking 

Notes,  126.  4.  Premature  Advice  and  Promises,  129.  5.  Bringing 

the  Interview  to  a  Close,  130.  6.  Emergency  Interviews,  13 1. 

Summary 

Chapter  VII 

The  Family  Group 

I.  The  Family  as  a  Whole 

1.  The  Main  Drift  of  the  Family  Life,  138.  2.  The  United  and  the 

Unstable  Family,  139. 

II.  The  Husband  and  Father 

1.  The  Man  Should  Be  Seen,  143.  2.  place  of  Interview,  143.  3. 

The  Unmarried  Father,  144.  4.  The  Yopng  Couple,  145.  5.  De¬ 

sertion  and  Inebriety,  146. 

III.  The  Wife  and  Mother 

1.  Physical  Aspects  of  Homemaking,  148.  ■?-  The  Family  Housing, 

I5I- 

IV.  The  Children 

1.  The  Matter  of  Ages,  154.  2.  The  Older  Children,  155. 

V.  Other  Members 
Summary 

14 


PAGE 

8l 

8l 

85 

87 


94 


99 


103-- 

104 


1 1 1 

1 15 


132 

134 

137 


143 


147 


152 

1 56 
158 


TABLE  OF  CONTENTS 


.  Chapter  VIII  PAGE 

Outside  Sources  in  General  160 

I.  Statistics  of  Outside  Sources  161 

i.  A  Study  of  the  Sources  Most  in  Use,  1 6 1 .  2.  Nature  of  Sources, 

164. 

II.  Principles  Governing  the  Choice  of  Sources  46^ 

1.  First  Principle  of  Choice,  170.  2.  Second  Principle  of  Choice,  170. 

3.  Third  Principle  of  Choice,  172.  4.  Fourth  Principle  of  Choice,  174. 

5.  Fifth,  Sixth,  and  Seventh  Principles  of  Choice,  175. 


III.  Method  176 

Summary  179 

Chapter  IX 

Relatives  as  Sources  180 

I.  The  Case  against  Relatives  181 

1.  Relatives  Are  Partisan  and  Prejudiced,  18 1 .  2.  Relatives  Do  Not 

Know,  183.  3.  Relatives  Do  Not  Understand,  183. 

1 1 .  The  Case  for  Relatives  186 

1.  Individual  and  Family  History,  186.  2.  Insight,  188.  3.  Backing 

and  Active  Co-operation,  189.  4.  Further  Considerations,  194. 

III.  Questions  of  Support  from  Relatives  195 

IV.  Methods  of  Approach  200 

Summary  202 

Chapter  X 

Medical  Sources  204 

I.  Where  Medical  Evidence  Sometimes  Fails  205 

1.  Non-social  Attitude,  205.  2.  Conflicting  Diagnoses  and  Prog¬ 
noses,  206.  3.  Faulty  Medical  Records,  207. 

II.  Complementary  Nature  of  Medical  and  of  Social  Data  207 

III.  Social  Responsibility  for  Early  Medical  Diagnosis  21 1 

IV.  Method  213 


1.  Ask  for  Prognosis,  213.  2.  Economize  Resources,  213.  3.  Seek 

First-hand  Information,  215.  4.  A  Medical  Diagnosis  Should  Have 

a  Date,  216.  5.  Beware  the  Medical  Opinions  of  the  Non-medical, 

216.  6.  Doctor  to  Doctor  Is  More  Frank,  216.  7.  Careful  Reporting 

Wears  Away  Prejudice,  218.  8.  Miscellaneous  Suggestions,  218. 


Summary  219 

Chapter  XI 

Schools  as  Sources  221 

I.  The  Social  Evidence  of  Teachers  223 

1.  Grade,  223.  2.  Scholarship,  224.  3.  Attendance,  225.  4.  Be¬ 
havior,  226.  5.  Physical  Condition,  227.  6.  Mental  Condition,  227. 

7,  Home  Care,  229.  8.  Results  of  Social  Trea.tment,  230. 

II.  Method  232 

Summary  234 

15 

2,Ct> 

103. 


TABLE  OF  CONTENTS 


Chapter  XII  PAGE 

Employers  and  Other  Work  Sources  235 

I.  Uses  and  Scope  of  a  Work  Record  236 

1.  Uses,  236.  2.  Scope,  239. 

II.  Certain  Failures  of  Employer  Testimony  240 

III.  The  Co-operation  of  Employers  242 

1.  Former  Employers,  242.  2.  Present  Employers,  244.  3.  Prospec¬ 
tive  Employers,  245. 

IV.  Method  246 

1.  The  Approach,  246.  2.  Accident  Cases,  247.  3.  Foreign  Work¬ 

men,  248. 

V.  Miscellaneous  Work  Sources  250 

Summary  252 

t 

Chapter  XIII 

Documentary  Sources  253 

I.  Present  Use  of  Documents  255 

1 .  Birth  and  Death  Records,  256.  2.  Marriage  and  Divorce  Records, 

258.  3.  Records  Indicating  Whereabouts,  260.  4.  Property  Records, 

262.  5.  Immigration  Records,  264.  6.  Records  of  Conduct,  265. 

II.  Use  of  Directories  and  Newspaper  Files  265 

III.  Method  269 

Summary  271 

Chapter  XIV 

Neighborhood  Sources  273 

I.  Present  Neighbors  274 

II.  Former  Neighbors  278 

III.  Landlords  280 

IV.  Other  Neighborhood  Sources  282 

Summary  283 

Chapter  XV 

Miscellaneous  Sources  284 

I.  Public  Officials  285 

1.  Police,  285.  2.  Other  Officials,  287. 

II.  Certain  Business  Sources  288 

III.  Fraternal  Orders  290 

Summary  291 

16 


TABLE  OF  CONTENTS 


Chapter  XVI  PAGE 

Social  Agencies  as  Sources  292 

I.  Two  Distinct  Functions  of  Social  Agency  Testimony  296 

1.  To  Supply  Data  from  Their  Own  Experience,  297.  2.  To  Supply 

the  Results  of  Their  Inquiries,  301. 

II.  The  Confidential  Exchange  303 

III.  The  Use  of  Exchange  Data  308 

IV.  Some  Further  Details  of  Co-operation  310 

1.  Duplicate  Investigations,  31 1.  2.  The  Transfer  to  Another 

Agency  for  Treatment,  313.  3.  Additional  Suggestions,  315. 

Summary  3 1 5 

^<ChapxerH^V?P 

Letters,  Telephone  Messages,  etc.  317 

I.  Blank  Forms  ^^18 

II.  Letters  of  Inquiry  319 


1.  Should  the  Letter  Be  Written  at  All?  320.  2.  Should  the  Letter 
Be  Written  Now?  321.  3.  What  Relation  Does  This  Particular  In¬ 

quiry  Bear  to  the  Whole  Process?  322.  4.  Has  the  Best  Correspond¬ 
ent  Been  Chosen  for  the  End  in  View?  323.  5.  What  Will  Interest 

the  Correspondent  Selected?  326.  6.  What  Presentation  Will  Save 

the  Correspondent  Unnecessary  Trouble?  327.  7.  What  Facts  re¬ 

lating  to  the  Correspondent’s  Occupation,  Education,  etc..  Should 


Modify  the  Approach  by  Letter?  331. 

III.  Letters  of  Reply  to  Inquiries  333 

IV.  Some  Technical  Details  *  '  335 

V.  Communication  by  Telegraph  336 

VI.  Communication  by  Telephone  337 

Summary  341 

Chapter  XVIII 

Comparison  and  Interpretation  342 

I.  Certain  Aspects  of  Earlier  Processes  Restated  342 


1.  Methods  Common  to  All  Interviews,  342.  2.  Changes  of  Empha¬ 
sis  in  Interviewing,  343.  3.  Discrimination  in  the  Choice  of  Outside 

Sources,  344.  4.  Types  of  Evidence,  346.  5.  Characteristics  of 

Witnesses,  346. 

II.  The  Comparison  of  Material  347 

1.  Suggestions  for  Self-supervision,  349.  2.  Suggestions  for  Com¬ 
parisons  Made  by  a  Supervisor,  351.  3.  The  Ames  Case,  352. 

III.  The  Interpretation  of  Material  355  y 

1.  Diagnosis  Redefined,  357.  2.  Diagnostic  Content,  358.  3.  The 

Time  Element,  361.  4.  Full  Diagnosis  Not  Always  Possible,  363. 

Summary  363 

2 


17 


TABLE  OF  CONTENTS 


Chapter  XIX 

The  Underlying  Philosophy 

I.  Individual  Differences 

II.  The  Wider  Self 

* 

PART  III 

VARIATIONS  IN  THE  PROCESSES 
Chapter  XX 

Social  Disabilities  and  the  Questionnaire  Plan  of 
Presentation 

I.  Objects  of  the  Questionnaires 

i.  Their  Dangers,  373.  2.  Their  Use  Illustrated,  374. 

II.  What  Is  True  of  Everybody? 

III.  What  Is  Possibly  True  of  Any  Family? 

Questionnaire  regarding  Any  Family 


Chapter  XXI 

The  Immigrant  Family  382 

I.  Study  of  the  Group  '  383 

II.  Study  of  the  Individual  386 

Immigrant  Family  Questionnaire  387 

Chapter  XXII 

Desertion  and  Widowhood  393 

Deserted  Family  Questionnaire  395 

Questionnaire  regarding  a  Widow  with  Children  400 

Chapter  XXIII 

The  Neglected  Child  405 

Questionnaire  regarding  a  Neglected  Child  405 

Chapter  XXIV 

The  Unmarried  Mother  „  413 

Questionnaire  regarding  an  Unmarried  Mother  414 

Chapter  XXV 

The  Blind  420 

Questionnaire  regarding  a  Blind  Person  421 

18 


TABLE  OF  CONTENTS 


Chapter  XXVI  PAGE 

The  Homeless  Man — The  Inebriate  425 

I.  The  Homeless  Man  425 

Homeless  Man  Questionnaire  425 

II.  The  Inebriate  429 

Inebriety  Questionnaire  430 

Chapter  XXVII 

The  Insane — The  Feeble-minded  434 

Questionnaire  regarding  a  Patient  Possibly  Insane  436 

Questionnaire  regarding  a  Child  Possibly  Feeble-minded  441 

Chapter  XXVIII 

Supervision  and  Review  449 

Supervision  and  Review  Questionnaire  449 

Appendices 

I.  First  Interviews  457 

1 1 .  Statistics  of  Outside  Sources  '  466 

III.  Specimen  Variable  Spellings  472 

Bibliography  483 

Index  489 


19 


LIST  OF  TABLES 

1.  Twenty  Sources  Most  Used  in  Three  Cities,  in  Order  of 

Frequency  of  Use  165 

2.  Order  of  Frequency  of  Consultation  in  the  Separate  Cities 

of  the  20  Sources  Most  Often  Used  in  the  Three  Cities 
Taken  Together  166 

3.  Twenty  Sources  Most  Used  by  Agencies  Doing  Work  with 

Children,  Family  Work,  and  Medical-social  Work  in  First 
City,  in  Order  of  Frequency  of  Use  168 

4.  Use  of  the  20  Sources  Most  Used  in  the  First  City,  by 

Agencies  Doing  Work  with  Children,  Family  Work,  and 
Medical-social  Work  in  That  City  169 

5.  Social  Agencies  (Exclusive  of  Health  and  School  Agencies) 

Used  as  Sources  by  56  Agencies  in  2,800  Cases  298 

Appendix  II 

A.  Sources  of  Information  Consulted  in  Three  Cities,  as 

Shown  by  the  Records  Examined  467 

B.  Sources  of  Information  Consulted  in  the  First  City  by 

Agencies  Engaged  in  Specified  Types  of  Work  470 


21 


PART  I 

SOCIAL  EVIDENCE 


CHAPTER  I 


BEGINNINGS 


THOUGH  the  social  worker  has  won  a  degree  of  recognition 
as  being  engaged  in  an  occupation  useful  to  the  community, 
he  is  handicapped  by  the  fact  that  his  public  is  not  alive  to 
the  difference  between  going  through  the  motions  of  doing  things 
and  actually  getting  them  done.  “  Doing  good”  was  the  old  phrase 
for  social  service.  It  begged  the  question,  as  do  also  the  newer 
terms,  “social  service”  and  “social  work” — unless  society  is  really 
served.  We  should  welcome,  therefore,  the  evident  desire  of  social 
workers  to  abandon  claims  to  respect  based  upon  good  intentions 
alone;  we  should  meet  halfway  their  earnest  endeavors  to  subject 
the  processes  of  their  task  to  critical  analysis;  and  should  encourage 
them  to  measure  their  work  by  the  best  standards  supplied  by 
experience — standards  which,  imperfect  now,  are  being  advanced 
to  a  point  where  they  can  be  called  professional. 

The  social  workers  of  the  United  States  form  a  large  occupational 
group.  A  majority  of  them  are  engaged  in  case  work1 — in  work, 
that  is,  which  has  for  its  immediate  aim  the  betterment  nf  Jndi- 
viduals  or  farmlipyzang  bv  rmer  as  di^tinguEAed-fr^>rn  their  better¬ 
ment  in  the  mass.  Mass  betterment  and  individual  betterment  are 
interdependent,  however,  social  reform  and  social  case  work  of 
necessity  progressing  together.  This  fundamental  truth  will  appear 
repeatedly  as  the  present  discussion  of  social  diagnosis  advances. 


1Thus,  a  study  made  of  the  social  workers  in  New  York  City,  which  does  not 
include  those  in  public  departments  or  public  institutions,  shows  that  the  private 
agencies  of  New  York  were  employing  in  salaried  positions  3,968  social  workers  in 
1915.  Of  this  number,  501  were  engaged  in  “community  movements — research  and 
propaganda.”  The  city  is  headquarters  for  a  large  majority  of  the  national  social 
reform  movements,  which  fact  accounts  for  the  size  of  this  second  figure;  in  any 
other  city  it  would  be  a  smaller  proportion  of  the  total.  All  the  other  social  workers 
counted  were  dealing  with  individuals,  but  some  of  these — settlements  and  recrea¬ 
tional  activities,  for  example — were  giving  an  unknown  proportion  of  their  time  to 
dealing  with  individuals  in  groups.  Deducting  these  also,  therefore,  approximately 
2,200,  the  number  remaining,  were  in  social  agencies  doing  case  work.  See  Devine, 
Edward  T.,  and  Van  Kleeck,  Mary:  Positions  in  Social  Work.  Pamphlet  of  the 
New  York  School  of  Philanthropy,  1916. 

25 


SOCIAL  DIAGNOSIS 


Since  social  case  work  is  too  large  a  subject  to  be  covered  in  one 
volume,  its  initial  process  alone  will  be  the  subject  of  this  book. 

When  a  human  being,  whatever  his  economic  status,  develops 
some  marked  form  of  social  difficulty  and  social  need,  what  do 
we  have  to  know  about  him  and  about  his  difficulty  (or  more  often 
difficulties)  before  we  can  arrive  at  a  way  of  meeting  his  need?1 
The  problem  may  be  one  of  childhood  or  old  age,  of  sickness,  of 
exploitation,  or  of  wasted  opportunity,  but  in  so  far  as  it  concerns 
some  one  individual  irLdiis--soaai_relationships  it  is  not  alien  to 
social  work  as  here  understood.  TheefforTTo^get  the  essential 
facts  bearing  upon  a  man’s  social  difficulties  has  commonly  been 
-  called  “an  investigation,”  but  the  term  here  adopted  as  a  substi- 
tute^social  diagnosis- — has  the  advantage  that  from  the  first  step 
it  fixes  the  mind  of  the  case  worker  upon  the  end  in  view.2  The 
primary  purpose  of  the  writer,  in  attempting  an  examination  of 
the  initial  process  of  social  case  work,  is  to  make  some  advance 
toward  a  professional  standard.  The  volume,  then,  is  addressed 
first  to  social  workers. 

But  another  audience  has  been  kept  in  view  in  its  preparation. 
Much  of  the  process  herein  described  is  undoubtedly  applicable, 
with  modification,  to  human  situations  which  do  not  come  within 
the  purview  of  social  work  as  now  organized.  The  special  field  of 
social  diagnosis  lies  in  social  case  work.  It  is  destined  in  addition 
to  become  an  adjunct  in  the  fields  of  medicine,  education,  juris- 

1  The  word  social  has  many  meanings.  Its  use  throughout  this  book  assumes  that 
wherever  there  are  two  individuals  instead  of  one,  human  association  or  society 
begins.  As  relations  among  human  beings  become  groupal,  they  continue  to  be 
social  even  in  groups  too  large  for  personal  contact,  provided  the  groupal  relation 
continues  to  influence  the  minds  of  the  units  which  compose  the  group.  The  more 
or  less  arbitrary  groupings  of  human  beings  in  which  no  such  influence  is  apparent 
(into  dependents  or  delinquents,  for  example)  are  often  described  as  social  too,  but 
they  do  not  here  concern  us.  When  Dr.  James  J.  Putnam  said,  in  the  passage  which 
is  one  of  the  mottoes  of  this  volume,  “It  is  in  each  man’s  social  relations  that  his 
mental  history  is  mainly  written,  and  it  is  in  his  social  relations  likewise  that  the 
causes  of  the  disorders  that  threaten  his  happiness  and  his  effectiveness  and  the 
means  for  securing  his  recovery  are  to  be  mainly  sought,”  he  was  writing  of  the 
patients  of  a  neurologist;  but  we  may  safely  assume  that  he  was  thinking  not  only 
of  the  intimate  personal  relationships  of  these  patients,  but  of  their  occupa¬ 
tions,  recreations,  and  total  of  social  contacts.  For  there  is  a  very  real  sense  in 
which  the  mind  of  man  is  the  sum  of  these  contacts.  Consideration  of  the  bearing 
of  this  concept  upon  our  subject  is  reserved  for  the  end  of  Part  II.  (See  Chapter 
XIX,  The  Underlying  Philosophy.) 

2  See  the  definitions  of  Chapter  III,  and  the  much  fuller  discussion  of  Chapter 
XVIII,  Comparison  and  Interpretation. 

26 


{ 


BEGINNINGS 


prudence,  and  industry.  While  knowledge  from  these  fields  is  being 
applied  to  social  case  work,  the  latter  has  developed  methods  that 
will  be  useful  in  return. 

In  this  new  discipline,  as  in  each  of  the  others,  discoveries  that 
were  made  with  pain  and  difficulty  by  the  pioneers  of  one  genera¬ 
tion  have  become  commonplaces  of  our  thinking  in  the  next.  There 
is  a  half  century  of  hard  social  endeavor  between  Edward  Denison’s 
despairing  exclamation — “  Every  shilling  I  give  away  does  four- 
pence  worth  of  good  by  helping  to  keep  their  [his  beneficiaries’] 
miserable  bodies  alive,  and  eightpence  worth  of  harm  by  helping 
to  destroy  their  miserable  souls”1 — and  the  request  made  by  a 
physician  in  an  American  city  a  few  years  ago.  This  physician, 
who  had  seen  in  his  hospital  practice  the  excellent  service  given 
by  the  trained  social  workers  of  the  hospital  in  unravelling  theX 
social  complications  of  its  patients,  asked  their  leader  to  let  him 
engage  one  of  them  to  render  like  service  to  a  private  patient  of 
his — a  patient  abundantly  able  to  pay,  and  unlikely  to  be  bene¬ 
fited  medically  without  social  treatment.  The  social  service  de¬ 
partment  of  the  hospital  was  unable  to  spare  a  worker  from  its 
staff,  but  recommended  one  with  the  requisite  qualifications  from 
the  staff  of  a  relief  society. 

The  point  to  be  noted  is  that  the  skilful  methods  which  made 
this  undertaking  possible  had  been  built  up  laboriously  by  those 
who  had  shared  Denison’s  questionings  and  later  by  several  case 
work  groups  which  struggled  forward  independently.  Important 
contributions  have  been  made  to  social  diagnosis  by  at  least  three 
of  these  groups — those  identified  with  the  charity-otganization,  the 
childreius-Geurt,  and  the  medical-social  movements.  In  the  first 
of  these  movements  interest  lrTdiagnosis  shows  two  divergent  im¬ 
pulses — one  toward  emphasis  upon, economic  status  to  the  exclu- 
sion  of  other  equally  important  aspects  of  human  affairs;  the  other 
toward  a  broader  conception,  which  led  its  advocates  from  the 
very  beginning — though  without  training  and  with  few  resources — 
to  take  the  whole  man  into  consideration.  In  the  children’s  court 
movement  some  of  the  methods  of  experimental  psychology  have 

1  Quoted  by  Mrs.  Josephine  Shaw  Lowell  in  “The  Evils  of  Investigation  and 
Relief,”  Charities,  July,  1898,  p.  9.  Denison  was  a  volunteer  almoner  in  i860  for 
the  London  Society  for  the  Relief  of  Distress. 

27 


SOCIAL  DIAGNOSIS 


Y 


been  adapted  to  the  needs  of  social  inquiry.  The  medica.-social 
movement  is  modifying  in  a  striking  way  both  medical  and  social 
practice. 

I.  THE  ECONOMIC  AND  THE  MORE  COMPREHENSIVE  APPROACH 

1.  The  Forerunners.  In  some  ways  it  was  unfortunate  that 
the  first  attempts  to  introduce  investigation  into  the  charitable 
treatment  of  dependency  (for  it  was  in  this  field  that  social  diag¬ 
nosis  had  its  beginnings)  were  made  by  soxiaLreformers^diawere 
pnrrmrjly  prnnnryikt^rir  who  took  their  cue  from  the  economists/^ 
This  came  about  from  the  fact  that  the  beginnings  of  social  diag¬ 
nosis  were  in  England,  where,  after  the  riot  of  sentimentality  in¬ 
terrupted  by  spasms  of  severity  which  had  passed  for  statesman¬ 
ship  in  the  treatment  of  distress  from  the  time  of  Elizabeth,  chari¬ 
table  reforms  attempted  in  the  first  quarter  of  the  nineteenth  cen¬ 
tury  gave  rise  to  the  phrase  “a  thorough  investigation.”  Thomas  ^ 
Chalmers  used  it  in  Glasgow  as  early  as  1823  in  connection  with 
his  parish  work,  and  later  it  was  used  by  the  systematizers  of  Ger¬ 
man  poor  relief  at  Elberfeld.1  On  the  other  hand,  the  Poor  L&w 
reformers  of  1834  turned  their  backs  upon  the  idea,  counting  upon 

1  See  Charles  R.  Henderson’s  edition  of  The  Christian  and  Civic  Economy  of 
Large  Towns  by  Thomas  Chalmers,  p.  261,  for  a  passage  on  individual  inquiry. 

The  reformers  of  poor  relief  in  Elberfeld,  Germany,  in  1852,  quoted  Chalmers,  but 
neither  then  nor  later  does  his  fine  spirit  seem  to  have  been  made  manifest  to  them. 

At  least,  in  an  undated  pamphlet  which  bears  internal  evidence  of  belonging  to  the 
early  ’70’s,  Andrew  Doyle,  an  English  Poor  Law  inspector,  could  introduce  a  de¬ 
scription  of  the  methods  of  inquiry  in  use  in  Elberfeld — methods  which  he  admired — 
in  these  terms: 

“  It  was  assumed  by  the  framers  of  the  English  Poor  Law,  and  is  still  assumed  by 
those  who  continue  to  take  any  interest  in  administering  it  upon  the  principle  upon 
which  it  was  founded,  that  no  real  test  of  destitution  can  be  devised  except  the  test 
of  the  workhouse.  As  the  application  of  that  test  is  as  yet  no  part  of  the  Elberfeld 
system,  it  will  be  asked — what  is  the  substitute  for  it? 

“  In  the  first  place  the  applicant  for  relief  is  subjected  to  an  examination  so  close 
and  searching,  so  absolutely  inquisitorial,  that  no  man  who  could  possibly  escape 
from  it  would  submit  to  it.  He  is  not  one  of  several  hundreds  who  can  tell  his  own 
story  to  an  overworked  relieving  officer,  but  one  of  a  very  few,  never  exceeding  four 
— frequently  the  single  applicant — who  is  bound  by  law  to  answer  every  one  of  that 
long  string  of  questions  that  his  interrogator  is  bound  by  law  to  put  to  him.  One 
of  the  peculiar  merits  claimed,  and  I  believe  rightly  claimed,  for  this  system  is  that 
before  a  man  can  obtain  relief  it  must  be  shown  that  he  cannot  exist  without  it.” — 

The  Poor  Law  System  of  Elberfeld,  p.  xv. 

Doyle  gives  a  long  list  of  minute  questions  which  each  applicant  must  answer. 

All  of  these  have  a  direct  relation  to  economic  status  with  the  exception  of  “religious 
profession,”  “the  state  of  health  of  each  member  of  his  family,”  and  “whether  or 
not  the  children  are  sent  to  school.” 

28 


BEGINNINGS 


willingness  to  enter  the  workhouse  as  a  test  of  destitution  and  upon 
the  workhouse  itself  as  a  deterrent  that  would  render  individualized 
inquiry  unnecessary.  Often  the  advocates  of  inquiry  in  those 
earlier  days  had  nothing  but  the  economic  aspects  of  a  given  human 
situation  in  mind,  and,  when  called  upon  to  explain  their  phrase, 

“a  thorough  investigation/’  emphasized  no  resources  save  those  of  ^ 
-income,  no  obligations  save  those  that  were  liabilities  of  relatives 
for  support  or  repayment.  The  treatment  they  contemplated, 
therefore,  looked  to  the  repression  of  unnecessary  demands  upon 
public  bounty  rather  than  to  the  release  of  energy,  the  regenerating 
of  character,  or  the  multiplication  of  health  opportunities,  oppor¬ 
tunities  for  training,  and  the  like. 

No  general  statement  such  as  this  can  be  entirely  fair.  Chalmers 
himself  was  a  man  of  genius  and  vision  who  saw  the  need  of  liberat¬ 
ing  the  powers  of  self-help  and  mutual  help  within  the  people 
themselves,  and  who  realized  the  part  that  personal  service  might 
play  in  this  task.  But  he  had  not  then  at  hand  most  of  the  materials 
out  of  which  modern  social  diagnosis  and  social  treatment  are  now 
in  process  of  being  built.  For  every  one  thing  that  could  then  be 
done  about  a  man’s  attitude  toward  his  life  and  his  social  relations* 
about  his  health,  housing,  work,  and  recreation,  there  are  now  a 
dozen  things  to  do.  The  power  to  analyze  a  human  situation  *. 
closely,  as  distinguished  from  the  old  method  of  falling  back  upon  t 
a  few  general  classifications,  grows  with  the  conscio^usiiess-of-power 
to  get  things  done* 

2.  Charity  Organization  Beginnings*  The  London  Charity  - 
Organization  Society,  heir  to  Chalmers’  ideas  and  student  of  the 
Elberfeld  system,  included  in  its  membership  from  the  beginning 
a  small  group  of  social  reformers  who,  while  impressed  with  the 
necessity  for  regulating  relief-giving,  especially  concerned  them¬ 
selves  with  efforts  toknlace  distressed  people  above  the  need  of 
relief  and,  in  doing  this,  to  study  and  release  their  latent  possi¬ 
bilities.  As  early  as  1869,  the  year  in  which  the  London  society 
was  founded,  Miss  Octavia  Hill  had  given,  before  the  Social  Science^ 
Association,  the  first  description  that  we  have  been  able  to  find 
of  inquiry  with  social  reinstatement  as  its  motive  and  aim.  It  is 
the  first  passage  in  which  the  human  being  himself,  in  his  social  as 
distinguished  from  his  economic  environment,  seems  to  emerge: 

29 


SOCIAL  DIAGNOSIS 


By  knowledge  of  character  more  is  meant  than  whether  a  man  is  a  dri  <  d  or 
a  woman  is  dishonest;  it  means  knowledge  of  the  passions,  hopes,  and  h  ry  cf 
people;  where  the  temptation  will  touch  them,  what  is  the  little  scheme  th  :;ave 
made  of  their  lives,  or  would  make,  if  they  had  encouragement;  what  training  long 
past  phases  of  their  lives  may  have  afforded;  how  to  move,  touch,  teach  them. 
Our  memories  and  our  hopes  are  more  truly  factors  of  our  lives  than  we  often 
remember.1 

From  that  day  to  this  the  struggle  in  the  charity  organization 
movement  between  what  may  be  termed  the  comprehensive  method 
of  inquiry  and  of  treatment  and  the  exclusively  economic  one  has 
gone  on.  Conditions  in  this  country  made  it  possible  for  Miss 
Hill’s  ideas  to  bear  fruit  here  more  promptly  than  in  England.  Her 
essays  made  a  profound  impression.  In  New  York,  the  State 
Charities  Aid  Association  reprinted  Homes  of  the  London  Poor  in 
1875,  while  in  Boston  the  system  of  “volunteer  visiting”  owed  its 
impulse  in  large  part  to  her  writings.  So  lasting  is  the  impress  of 
beginnings  that  even  today  it  is  possible  to  recognize  signs  of  Miss 
Hill’s  influence  and  of  the  spirit  of  her  1869  statement  in  the  current 
case  records  of  certain  of  the  American  charity  organization 
societies. 

In  a  number  of  the  American  societies,  however,  the  economic 
program  of  inquiry  was  for  a  long  time  the  more  usual  onej  Some 
of  the  earlier  documents  actually  describe  investigation  as  repres¬ 
sive.2  In  fact,  no  one  can  understand  the  diversity  in  the  charity 
organization  societies  of  today  who  does  not  realize  that  in  this 
country  the  early  movement  had  several  independent  beginnings, 
and  that,  in  one  of  these,  Miss  Hill’s  work  in  London  and  her  occa¬ 
sional  essays  were  the  shaping  influence,  while  in  some  of  the 
others  inquiry  and  treatment  centered  around  questions  of  relief 
or  no  relief. 

3.  First  Attempts  to  Establish  Standards.  It  is  to  the  credit 
of  the  societies  identified  with  the  broadest  of  these  initial  impulses 
that  they  have  been  dissatisfied  with  their  own  work.  Although 
they  have  failed  again  and  again  to  make  their  inquiries  into  indi¬ 
vidual  situations  skilful  and  effective,  they  have  been  aware  of 

1  Life  of  Octavia  Hill,  C.  E.  Maurice,  p.  258.  • 

2  See  especially  S.  Humphreys  Gurteen’s  Handbook  of  Charity  Organization^ 
published  by  the  author  in  Buffalo  in  1882.  While  in  some  passages  another  note 
is  struck,  on  p.  146  he  expressly  refers  to  investigation  as  repressive.  Some  Ameri¬ 
can  leaders  of  the  movement  were  doing  the  same  as  late  as  1904. 

30 


BEGINNINGS 


such  shortcomings  and  have  applied  themselves  to  achieving  a 
greater  measure  of  success.  Both  in  England  and  here  they  have 
attempted  to  formulate  experience.1  The  American  leaders  have 
protested,  moreover,  in  no  uncertain  terms  against  regarding  in¬ 
vestigation  as  an  end  in  itself,  without  reference  to  the  use  to  which 
the  information  obtained  may  be  put.  This  was  notably  true  of 
Mrs.  Josephine  Shaw  Lowell,  founder  of  the  New  York  society, 
who  wrote : 

We  had  in  New  Yo*k,  in  the  hard  times  of  1893  and  1894,  a  most  painful  experi¬ 
ence  in  this  regard.  The  very  word  “investigation”  seemed  then  to  have  been  made 
a  sort  of  shibboleth  by  the  newspapers,  and  in  too  many  cases,  by  the  ministers  also. 
To  every  remonstrance  against  methods  of  relief-giving  which  were  injurious  to  the 
character  of  those  who  were  supposed  to  be  helped  by  them,  and  cruel  in  their  entire 
disregard  of  their  comfort,  happiness,  and  moral  and  physical  well-being,  it  seemed 
to  be  considered  a  sufficient  answer  to  say:  “All  the  cases  have  been  thoroughly 
investigated,”  and  it  was  evidently  thought  that  this  answer  ought  to  be  entirely 
satisfactory  to  charity  organizationists,  even  though  the  investigations  were  made, 
not  for  the  purpose  of  furnishing  guidance  and  knowledge  for  a  long  course  of  “treat¬ 
ment”  by  which  weak  wills  might  be  strengthened,  bad  habits  be  cured,  and  in¬ 
dependence  developed,  but  in  order  that  a  ticket  might  be  given  by  means  of  which, 
after  a  long,  weary  waiting  in  the  street  in  the  midst  of  a  crowd  of  miserable  people, 
whose  poverty  and  beggary  were  published  to  every  passerby,  some  old  clothes  or 
some  groceries  might  be  got.2 

The  year  before  this  was  written  (1897),  Edward  T.  Devine, 
secretary  of  the  New  York  society,  made  a  strong  plea  for  improve¬ 
ment  in  the  personnel  of  thejnyjsstigators,  for  their  training,  and 
for  a  clearer  definition  of  the  end  .which  investigation  has  in  view. 

In  the  following  year  he  organized3  the  summer  course  of  training 
which  was  to  develop  later  into  the  New  York  School  of  philan-  ^ 
thropy,  the  first  of  the  training  schools  for  social  workers  established 
in  this  country.  The  opening  of  these  schools  gave  a  strong  im¬ 
petus  to  developments  already  under  way  in  social  agencies.  It 
became  more  apparent  than  ever,  for  example,  that  investigation 
was  not  merely  a  notion  of  the  charity  organization  societies,  that 

1  See,  for  example,  the  early  English  statement  of  C.  J.  Ribton-Turner: 
Suggestions  for  Systematic  Inquiry,  1872;  and  “How  to  Take  Down  a  Case”  in 
the  1896  Occasional  Papers  of  the  London  Charity  Organization  Society.  The  Bos¬ 
ton  Associated  Charities  has  given  us  Miss  M.  L.  Birtwell’s  all  too  brief  “Investi¬ 
gation”  ( Charities  Review,  January,  1895,  pp.  129-137). 

2  See  “The  Evils  of  Investigation  and  Relief”  in  Charities,  June,  1898. 

3  Under  the  directorship  of  Philip  W.  Ayres. 

31 


SOCIAL  DIAGNOSIS 


/ 


this  process  was  essential  wherever  the  reinstatement  of  a  human 
being  was  to  be  attempted.  On  the  other  hand,  practical  instruc¬ 
tion  in  social  diagnosis  and  treatment  was  made  possible  for  the 
school  students  by  the  case  work  opportunities  (analogous  to  the 
“bedside  opportunities”  in  medical  instruction)  offered  to  them 
from  the  beginning  by  the  charity  organization  societies  and  later 
by  other  agencies.  Case  work  cannot  be  mastered  from  books  or 
from  class  room  instruction  alone,  though  both  have  their  place 
in  its  mastery. 

If  social  case  work  is  indebted  to  the  schools  and  the  social  f" 
agencies  jointly  for  their  encouragement  of  a  technique  in^common, 
it  must  look  to  social  reform  to  make  possible  a  technique  that  is 
varied  and  flexible.  New  methods  of  social  treatment  have  been 
developed  by  the  charity  organization  campaigns  for  better  hous¬ 
ing  and  for  the  prevention  of  tuberculosis;  by  the  long  struggle  of 
another  group  of  social  reformers  to  secure  diagnosis  and  care  of 
the  feeble-minded;  by  child  labor  reform,  by  industrial  legislation, 
by  the  recreation  movement,  the  mental  hygiene  movement,  and 
a  host  of  other  social  reforms.  The  significance  of  these  reforms 
here  is  that,  after  they  had  achieved  a  measure  of  success,  case  work 
treatment  had  at  its  command  more  varied  resources,  adaptable 
to  individual  situations,  and  that  therefore  the  diagnosis  of  those 
situations  assumed  fresh  importance. 

"Summing  up  the  main  facts  of  the  relation  of  charity  organiza-\ 
tion  to  social  diagnosis,  it  may  be  said,  Firsts  that  the  movement  \ 
developed  and  fought  for  the  beginnings  of  this  process.  Second, 
that  some,  of  its  earliest  leaders  had  grasped  the  idea  of  the  sym- 
P at h e. t'LC-Sti1  d \yof  the  individual  in  his  social  environment.  Third, 
that  this  conception,  imperfectly  realized,  was  often  thrust  aside 
by  belli  i r  e  commanding  importance  of  economic  data.  Fourth, 
that  prcc  ess  in  diagnosis  necessarily  awaited  the  development  of 
varied  n  ethods  of  treatment,  there  being  at  first  no  accepted  pro- 
gram  of  treaimentmther  than  the  giving  or  withholding  of  relief.1 
Fifth,  that  the  promotion  of  preventive  measures  which  made 
varied  treatment  possible,  notably  "ot  those  lookmgfto  the  better 


/ 


1  Here  and  here  individuals  and  agencies  had  broader  conceptions  of  what  could 
be  done,  but  in  the  earlier  days  these  were  carried  out  with  difficulty  against  the 
main  current  of  charitable  activity,  which  ran  strongly  toward  dole-giving. 

32 


BEGINNINGS 


housing  and  health  of  the  people,  became  an  important  part  of 
charity  organization  work. 


II.  THE  APPROACH  BY  WAY  OF  CHILD  STUDY 
Movements  more  or  less  independent  in  origin  may  act  and 
react  upon  one  another  in  such  a  way  as  to  make  it  difficult  to 
unravel  their  beginnings.  The  idea  of  juvenile  probation,  for  ex¬ 
ample,  goes  back  to  the  16o's.  The  Boston  Children's  Aid-Society 
and  later  (1869)  a  state  visiting  agency  which  was  established  in 
Massachusetts  interested  themselves  in  probation.  In  addition, 
the  Boston  Municipal.  Court  began  to  hold  separate  hearings  of 
children's  cases.  It  was  not  until  jlk&u  however,  when  repre¬ 
sentatives  of  the  women's  clubs,  the  children's  agencies,  and  the 
social  settlements  in  Chicago  were  able  to  secure  the~passage  of  a- 
iuLvenile  court  law,  combining  the  ideas  of  probation,  separate  liear- 
ingStr'and  the  specialized  judge,  ThatThe  -first  juvenile  court  was 
organized. 


The  contribution  of  the  children's  court  movement  to  social 
diagnosis  deserves  more  than  passing  mention.  It  drew  upon  the 
family  agencies,  and  upon  the  children's  agencies  even  more  largely, 
for  its  technique;  but  it  developed  a  point  of  view  of  its  own,  as 
is  shown  by  the  following  passage  in  which  Judge  Harvey  H.  Baker 
of  the  Boston  Juvenile  Court  describes  the  duty  of  the  judge: 


In  determining  the  disposition  to  be  made  of  the  case  the  procedure  of  the  physi¬ 
cian  is  very  closely  followed.  The  probation  officer  investigates  the  case  and  reports 
to  the  judge  all  available  information  about  the  family  and  other  features  of  the 
environment  of  the  boy,  the  boy’s  personal  history  at  home,  in  school,  at  work,  and 
on  the  street,  and  the  circumstances  attending  the  particular  outbreak  which  got 
him  into  court.  The  boy  himself  is  scrutinized  for  indications  of  feeble-mindedness 
or  physical  defects,  such  as  poor  eyesight,  deafness,  adenoids.  The  judge  and  pro¬ 
bation  officer  consider  together,  like  a  physician  and  his  junior,  whether  the  out¬ 
break  which  resulted  in  the  arrest  of  the  child  was  largely  accidental,  or  whether  it 
is  habitual  or  likely  to  be  so;  whether  it  is  due  chiefly  to  some  inherent  physical  or 
moral  defect  of  the  child,  or  whether  some  feature  of  his  environment  is  an  impor¬ 
tant  factor;  and  then  they  address  themselves  to  the  question  of  how  permanently 
to  prevent  the  recurrence.1 

Two  years  before  this  was  written,  the  judge  of  the  Chicago*' 
j  uvenile  Court  had  begun  to  urge  the  importance  of  procuring/iru 

1  The  Survey,  February  5,  1910,  p.  649. 

33 


3 


SOCIAL  DIAGNOSIS 


/ 

r 


addition  to  family  histories,  thorough  physical  and  mental  exami¬ 
nations  for  all  court  children^  This  court  was  the  first  social  agency 
to  utilize  to  the  full  applied  psychology — a  source  of  insight  the , 
use  of  which  had  been  developed  in  the  psychological  clinic  only  a 
few  years  before  the  Chicago  court  was  organized.2 
Institute  was  organized  in  connection  with  the  court  in  1909. 

This  kastitute  has  bppn  f the  d j rlioalLf  P r 


William  Healy,,_  whose  three  books — The  Individual  Delinquent, 
Pathological  Lying,  and  Honesty — embody  the  results  of  his 
institute  studies  of  juvenile  court  children.  Social  case  workers 
read  these  books  with  more  interest  than  they  do  any  others  relat¬ 
ing  to  child  study.  Although  The  Individual  Delinquent  is  “a 
text-book  of  diagnosis  and  prognosis  for  all  concerned  in  under¬ 
standing  offenders/'  its  discussion  of  method  contained  in  the  first 
third  of  the  book  makes  it  a  text-book  for  all  engaged  in  the  study 
of  human  beings.  In  his  simpler  statement,  Honesty,  intended  for 
teachers  and  parents,  Dr.  Healy  holds  a  similar  point  of  view  re¬ 
garding  the  influences  to  be  brought  to  bear  upon  character  to  that 
developed  nearly  fifty  years  before  from  a  different  angle  and  with 
a  different  equipment  by  Miss  Octavia  Hill.  He  believes  that  steal¬ 
ing  is  usually  a  symptom,  not  a  disease,  and  that  the  physical, 
mental,  and  social  facts  behind  that  symptom  must  be  grasped  and 
interpreted  if  we  are  to  effect  a  cure. 


III.  THE  MEDICAL  APPROACH 

In  the  earlier  days  of  the  charity  organization  movement  in  this 
country,  physicians  used  to  appeal  to  the  societies  to  advocate  the 
adoption  of  some  form  of  inquiry  by  hospitals  and  dispensaries  to 
prevent  the  fraudulent  use  of  free  medical  charities  by  those  who 
could  afford  to  pay.  This  is  another  instance  of  that  inadequate 
conception,  already  mentioned,  of  a  problem  which  presents  aspects 

1  See  Judge  Julian  W.  Mack’s  address  in  Proceedings  of  National  Conference  of 
Charities  and  Correction  for  1908  (Richmond,  Va.),  p.  374. 

2  As  early  as  1896  Lightner  Witmer  oTthe  University  of  Pennsylvania  had  opened 
such  a  clinic  and  had  begun  to  receive  children  for  examination  from  schools  and 
children’s  agencies;  later  he  did  examining  also  for  the  juvenile  court.  The  exami¬ 
nations  as  now  made  at  the  University  of  Pennsylvania’s  clinic  are  physical  and 
social  as  well  as  mental.  Ten  years  later  (1906)  Henry  H.  Goddard  began  his  work 
for  the  feeble-minded  at  Vineland,  N.  J.,  and  developed  the  use  of  the  Binet-Simon 
measuring  scale. 

34 


/ 


BEGINNINGS 


of  greater  significance  for  social  treatment  than  the  exclusively 
economic. 

Doctors  and  charity  organization  workers  co-operated  to  better 
purpose  when  the  New  York  Charity  O r ga nizati on-Socle-tv  began 
in  1902,  through  a  special  committee  on  tuberculosis,  its  first  cam¬ 
paign  for  the  prevention  of  disease.  Other  movements  for  improv¬ 
ing  public  health  soon  followed,  some  initiated  by  the  medical  pro¬ 
fession  and  some  by  social  workers.  Although  each  one  of  these 
has  influenced  social  diagnosis,  the  most.. direct  influence  exerted 
upon  this  process  by  the  medical  professionxQmesfxqm  the  medical- 
^Qcial  service  movement. 

M  edlcal-socTaTser vi ce  ow^ljLJ2HginJl^  Xf 

who  in  1905  orgamze3~the  first  social  service  ^department  jnthe 
out-patient  department  of  the  Massachusetts  General  Hospital 
It  was  “conceived  by  a  physician  who,  in  seeking  the  improvement 
of  dispensary  practice,  found  in  the  social  worker  a  potent  means  'y/ 
for  more  accurate  diagnosis  and  more  effective  treatment/'1  What 
Dr.  Cabot  had  in  mind  in  bringing  trained  social  workers  into  the 
dispensary  and  later  into  its  separate  clinics  was  not  a  mixture  of 
medical  and  social  work  but  their  chemical  union.  The  fuller 
development  of  this  idea  in  recent  years  is  best  described  in  his 
own  words: 

In  our  own  case  work  in  the  social  service  department  of  the  Massachusetts 
General  Hospital  we  are  accustomed  to  sum  up  our  cases  in  monthly  reports  from 
the  case  records  by  asking  about  each  case  four  questions:  What  is  the  physical 
state  of  this  patient?  What  is  the  mental  state  of  this  patient?  What  is  his  physi¬ 
cal  environment?  What  is  his  mental  and  spiritual  environment?  The  doctor  is 
apt  to  know  a  good  deal  about  the  first  of  those  four  things,  the  physical  state,  and 
a  little  about  the  second,  the  mental,  but  about  the  other  two  almost  nothing.  The 
expert  social  worker  comes  with  those  four  points  in  mind  to  every  case.  It  is  of 
interest  to  notice  that  this  fourfold  knowledge  is  not  the  goal  of  the  social  worker 
merely;  it  is  the  goal  of  every  intelligent  human  being  who  wants  to  understand 
another  human  being.  Suppose  a  man  was  about  to  be  married  to  a  member  of 
your  family  and  you  wanted  to  know  whether  he  deserved  this  great  promotion. 

You  would  want  to  know  just  those  four  things  the  social  worker  needs  to  know 
.  .  .  (a)  his  physical  condition,  (b)  his  character,  (c)  the  physical  condition 

under  which  he  has  been  brought  up  and  lives,  and  (d)  the  mental  and  spiritual 
influences  under  which  he  has  grown  up  and  now  lives.  It  would  be  the  same  if  you 
were  studying  candidates  for  a  paying  teller’s  position,  for  a  governor’s  position, 

1  From  Social  Work  in  Hospitals,  by  Ida  M.  Cannon,  p.  15  sq. 

35 


SOCIAL  DIAGNOSIS 


for  the  headship  of  a  college,  or  for  president  of  the  United  States.  Social  work,  as 
I  see  it,  takes  no  special  point  of  view;  it  takes  the  total  human  point  of  view,  and 
that  is  just  what  it  has  to  teach  doctors  who  by  reason  of  their  training  are  disposed 
to  take  a  much  narrower  point  of  view.  They  can  safely  and  profitably  continue 
that  narrow  outlook  only  in  case  they  have  a  social  worker  at  their  elbow,  as  they 
should  have,  to  help  them.  Each  of  us  has  his  proper  field,  but  we  should  not  work 
separately,  for  the  human  beings  who  are  our  charges  cannot  be  cut  in  two.1 


The  half  of  the  senior  class  of  medical  students  at  Harvard  who 
take  their  clinical  work  at  the  Massachusetts  General  Hospital 
also  take  a  course  there  in  medical-social  work  under  its  chief  of 
social  service,  and  some  of  the  medical  colleges  in  other  cities  give 
similar  instruction.  Even  more  directly  related  to  our  subject  is 
the  systematic  instruction  in  medical  matters  which  this  Boston 
medical-social  department  now  gives  to  non-medical  social  workers. 
I ndeed,  the  medical-social  rnnvement  has  had  a  marked-influence 
^  upon  the  daily  work  of  other  social  agencies  by  giving  them  a 
clearer  notion  of  the  bearing  of  health  upon  the  social  welfare  of 
the  individual. 


All  of  these  streams  of  experience — the  judicial,  the  psycholog¬ 
ical,  and  thelnedicaF — are  modifying  social  ise  work  profoundly, 
and  as  i n dfcafecRa r  1  ier  are  being  modified  by  it  in  turn.  .  A  ten¬ 
dency  to  drift  away  from  effective  standards  is  sometimes  notice¬ 
able,  however,  in  the  social  work  connected  with  court  or  clinic. 
The  explanation  of  this  lies  in  the  fact  that  long  established  pro¬ 
fessions  cast  a  long  shadow.  They  have  their  traditions,  their 
routine  erf  procedure,  their  terminology,  their  sense  of  professional  ^ 
solidarity.  Social  work  has  few  of  these  things.  When,  there-, 
fore,  the  doctor  or  judge  receives  social  workers  as  an  adjunct  to 
his  clinic  or  court,  he  may  have  but  a  dim  idea  of  the  distinctive 
contribution  of  authenticated  and  interpreted  social  fact  which 
they  should  bring  to  his  professional  work.  In  this  case,  he  tends 
to  fit  them  into  the  traditions  of  his  own  calling,  and  to  ignore  the 
characteristics  of  theirs.  The  judge  has  been  known  to  use  them 
for  detective  work;  the  physician,  accustomed  to  implicit  obe¬ 
dience  from  nurses,  may  use  them  for  errands  to  patients  or 
for  semi-clerical  service.  One  unfortunate  result,  apart  from 
the  waste  of  opportunity,  is  that  if  any  social  observations  are 


1  Proceedings  of  the  National  Conference  of  Charities  and  Correction  for  1915 
(Baltimore),  p.  220  sq. 


36 


BEGINNINGS 


possible  and  if  any  social  statements  are  taken,  they  are  accepted 
at  their  face  value  hv  professional  men  who  are  accustomed  in  thei r 
own  field  to  apply  rigid,  tests,  but  who  fail  to  recognize  the  need 
or  the  possibility  of  testing,  social  evidence.  The  nature  of  social 
evidence  and  the  tests  which  social  experience  and  the  principles 
of  reasoning  should  enable  us  to  apply  to  it  will  be  the  theme  of  the 
next  four  chapters. 


37 


V  p' 


CHAPTER  II 


THE  NATURE  AND  USES  OF  SOCIAL  EVIDENCE 


THE  processes  which  lead  up  to  social  diagnosis  and  thence  to 
the  shaping  of  a  plan  of  social  treatment  may  be  divided  into 
the  collection  of  evidence  and  the  drawing  of  inferences  there- 

1  ■■  i  im i  inni<fmfiijpiiw<ti!Wiii^|i  i  "ft*11  * 

from.  The  collection  of  evidence  comes  through  the  social  worker’s 
first  relations  (i)  with  his  client,1  (2)  with  his  client’s  family,  and 
(3)  with  sources  of  insight  outside  the  family  group.  These  stages 
will  all  be  described  in  detail  in  Part  II,  as  will  also  the  further 
stage  (4)  of  comparing  the  evidence  gathered  from  these  various 
sources  (inference),  and  of  interpreting  its  meaning  (diagnosis). 


I.  SOCIAL  EVIDENCE  DIFFERENTIATED 

From  the  beginning  of  his  task  the  social  case  worker  deals  with 
testimonial  evidence  in  a  way  shaped  by  the  end  for  which  it  was 
obtained;  namely,  the  social  treatment  of  individuals.  As  he  pro¬ 
ceeds  he  often  finds  himsefTThTrml-of  more  knowledge  as  to  the 
weight  which  should  be  attached  to  the  social  evidence  he  has 
gathered.  Are  there  rules  of  evidence,  principles  of  choice,  that  can 
guide  him  in  selecting  from  a  group  of  unassorted  observations  and 
testimonies  those  which  he  can  rely  upon  from  those  which  must 
be  accepted  “with  a  grain  of  salt”?  If  so^  are  these  principles 
peculiar  to  social  work,  so  that  its  practitioners  will  be  obliged  to 
dig  them  out  from  their  own  experience  alone,  or  may  they  hope 
to  find  them  already  identified  in  law  book  or  laboratory? 

That  there  are  such  rules  to  guide  the  social  worker  is  intimated 

1  Those  with  whom  social  case  workers  are  dealing  are  called  by  many  names — 
applicants,  inmates,  cases,  children,  families,  probationers,  patients  are  only  a  few 
of  them.  One  word  will  be  used  for  all,  usually,  in  this  volume — the  word  “client." 
Its  history  is  one  of  advancement  from  low  estate  to  higher.  First  it  meant  “a 
suitor,  a  dependent."  Later  it  meant  “one  who  listens  to  advice,”  and  later  still 
“one  who  employs  professional  service  of  any  kind.”  The  more  expert  the  service, 
the  more  appropriate  the  word,  which  has  the  advantage,  moreover,  of  democratic 
implications.  When  a  public  defender  in  California  serves  defendants  too  poor  to 
employ  him,  he  still  thinks  of  them  as  his  clients. 

38  - 


THE  NATURE  AND  USES  OF  SOCIAL  EVIDENCE 


by  a  correspondent  who  had  gone  from  a  charity  organization 
society  to  a  society  to  protect  children  from  cruelty.  He  writes: 

As  a  result  of  my  experience  both  with  C.  O.  S.  and  with  S.  P.  C.  C.  investigators, 
there  seems  to  me  a  weakness  in  the  training  of  the  C.  O.  S.  district  secretary,  who 
from  the  nature  of  her  duties  is  constantly  required  to  weigh  evidence  but  who  has 
not  got  clearly  in  mind  the  fundamental  differences  between  different  classes  of 
evidence  and  their  different  values.  I  do  not  now  refer  to  the  nice  discriminations; 
those  I  am  content  to  leave  to  trained  lawyers  to  squabble  over.  Not  only  would  the 
co-operation  with  an  S.  P.  C.  C.  be  at  once  improved  but  evidence  as  it  stands  in 
a  C.  O.  S.  investigation  would  be  increased  in  value  and  reduced  in  bulk.  I  confess 
to  considerable  impatience  at  times  when  I  find  district  secretaries  of  some  and  even 
of  great  experience  apparently  valuing  every  statement  equally  and  then  adding  the 
items  together  to  find  a  total. 

Many  will  share  this  correspondent's  impatience  with  such 
arithmetic.  Nevertheless,  no  considerable  group  of  social  case 
workers — whether  in  a  society  to  protect  children  or  a  charity 
organization  society  or  anywhere  else — seem  to  have  grasped  the 
fact  that  tjie  reliability  of  the  evidence  on  which  they  base  their 
decisions  shouldbe  noless  rigidly  scrutinized  than  is  that  of  legal 
evidence  by  opposing  counseLl  On  the  other  hand,  the  question  of 
admissibility,  the  rules  for  which  were  framed  mainly  to  meet  the 
average  juryman's  lack  of  skill  in  testing  evidence,  does  not  enter 
into  the  weighing  of  facts  as  gathered  by  an  agency  all  in  whose 
service  are,  or  can  be,  trained  to  this  special  task.  SkilHnjbesting 
evidence,  as  leading. to  such  proof  as  social  workers  need,  is  in  no 

€y  dependent  upon  a  knowledge  of  the  legal  rules  of  admissibility. 
:ial  evidence,  like  that  sought  by  the  scientist  or  historian, 

_ des  all  items  which,  however  trifling  or  apparently  irrelevant 

when  regarded  as  isolated  facts,  may,  when  taken  together,  throw_ 
light  uponqhe-jqiiestion  at  issue:  namely,  as  regards  social  work, 
the  question  what  coui^  of  procedure  will  place  this  client  in  his 
right  relation  to  society?  !  Many  an  item,  such  as  a  child's  delayed 
speech,  for  instance,  may  have  no  significance  in  itself,  whereas 
when  considered  in  connection  with  late  dentition  and  walking  and 
with  convulsions  it  may  become  a  significant  part  of  evidence  as 
to  the  child’s  mentality,  f  SociaJLevidence,  then,  has  an  advantage 
over  legal  evidence  intharTT'carimcTu 

value?|  Without  this  advantage  social  case  work  would  not  be 
possible,  since  the  problem  of  the  orientation  of  a  family  or  indi- 

39 


lAj: 


SOCIAL  DIAGNOSIS 


vidual  is  far  more  complex  than  the  single  question  as  to  whether 
or  not  a  litigant  or  a  defendant  is  to  be  penalized.  Moreover,  facts 
having  a  subjective  bearing,  like  that  of  delayed  speech  just  in¬ 
stanced,  are  especially  characterized  by  their  cumulative  signifi¬ 
cance.  Variations  between  people  in  mental  endowment,  in  “per¬ 
sonality/'  display  themselves  ordinarily  not  in  a  few  conspicuous 
acts,  but  in  a  trend  of  behavior  evidenced  by  innumerable  trifling 
remarks  or  by  a  succession  of  decisions  and  impulses  each  unim¬ 
portant  in  itself.  {Evidence  of  this^  cumulative  sort,  therefore,  is 
essential  wherever,  as  in  ial  work,,  decisions,  rest  upon  intimate 


understanding  of  character 


In  examining  the  reliability  of  evidence,  social  case  work  should 
make  its  own  application  of  universal  tests;  and,  coming  late  to 
the  task,  should  be  able  to  profit  by  the  e^erknces  not  merely  of 
law,  but  of  history  and  of  natural  science.  The  various  professions 
apply  rules  of  evidence  for  arriving  at  truth,  each  according  to  its 
own  special  conditions.  The  scientist  uses  controljed  experimen¬ 
tation  because  he  works  with  material  which  tnaybe  brought  under 
complete  control.  He  may,  for  instance,  till  half  of  an  orchard 
whose  physical  conditions,  soil,  grade,  exposure,  etc.,  are  the  same 
throughout.  If  the  tilled  half  bears  much  better  than  the  untilled, 
he  concludes  that  tilling  increases  the  product  of  fruit  trees.  When, 
however,  the  farmer  in  the  fable  digs  in  his  orchard  for  buried 
treasure,  and  in  place  of  gold  finds  his  promised  fortune  in  an 
unprecedented  yield  of  fruit,  he  probably  draws  no  causal  inferences 
whatever. 

Should  a  social  worker  have  the  task  of  showing  whether  the 
farmer’s  labor  had  paid  or  not,  he  would  get  the  testimony  of  the 
farmer,  of  his  family,  and  his  neighbors  as  to  the  previous  care  of 
the  trees;  their  evidence  as  to  any  other  measures  of  improvement 
he  might  have  taken,  such  as  pruning,  thinning  out,  etc.;  their 
recollection,  corroborated  by  governmepfal  reports,  of  weather 
conditions,  pests,  etc.,  of  preceding  years.  He  would  take  account 
of  hearsay  evidence,  of  persistent  rumors,  of  the  general  appearance 
of  the  man’s  farm  and  home.  As  a  result,  the  social  worker  might 
establish  or  discredit  the  value  of  tillage  in  this  instance  with  a  fair 
degree  of  probability. 

Suppose  on  the  other  hand  some  decision  in  a  law  court  should 


THE  NATURE  AND  USES  OF  SOCIAL  EVIDENCE 


turn  on  the  question  whether  or  not  it  was  his  tilling  of  the  soil 
that  had  brought  the  farmer  an  increased  yield  of  fruit.  The  court 
would  deal  in  the  main  with  the  same  facts  as  the  social  worker, 
namely,  with  the  testimony  of  witnesses,  with  government  reports, 
or  with  an  inspection  of  the  premises;  the  difference  would  be  that 
a  court  would  guard  with  scrupulous  care  the  admission  of  hearsay 
evidence  and  would  exclude  rumors;  that  it  would,  in  short,  hold 
each  witness  to  a  responsibility  for  his  statements,  allowing  him  in 
the  main  to  say  nothing  of  which  his  own  knowledge  was  not  first¬ 
hand.  This  evidence  might  or  might  not  satisfy  the  court  beyond 
a  reasonable  doubt  that  it  was  justified  in  concluding  that  tillage 
had  increased  the  farmer’s  yield.  But  these  restrictions  upon 
evidence  are  necessary  in  law  because  of  the  obligation  the  judge  is 
under  of  sifting  evidence  for  a  jury  who  are  liable  to  allow  undue 
weight  to  items  which  have  small  value  as  proof. 

The  common  difference  between  the  point  of  view  of  social 
worker  and  court  stands  out  in  the  following  instance  of  alleged 
parental  neglect : 


SOCIAL  EVIDENCE  WHICH  LED 
A  CASE  WORK  AGENCY  TO  ASK 
COURT  ACTION  THROUGH  A  SO¬ 
CIETY  TO  PROTECT  CHILDREN 

i.  Three  rachitic  children  aged  seven, 
five,  and  three  years;  the  oldest  could 
not  walk  at  all  at  four  years;  the  second 
and  third  had  bowed  legs  and  walked 
with  difficulty  at  three  years  old.  Al¬ 
though  the  oldest  child  has  been  three 
and  a  half  years  in  a  hospital  where  it 
was  sent  by  a  social  agency,  the  parents 
omitted  to  take  the  other  children  to 
the  dispensary  for  examination  and  ad¬ 
vice.  The  social  worker  made  seven 
calls  to  urge  them  to  do  this.  They  as¬ 
sented  each  time,  but  were  increasingly 
resentful  at  what  they  regarded  as  an 
intrusion  into  their  private  affairs,  and 
did  nothing.  The  social  worker  con¬ 
strued  this  as  parental  neglect. 


REASONS  WHY  THE  SOCIETY  TO 
PROTECT  CHILDREN  BELIEVED 
THAT  THE  COURT  WOULD  NOT 
ACT 

i.  “No  doctor  has  yet  made  a  definite 
statement  as  to  the  serious  result  of 
failure  on  the  parents’  part  to  follow  di¬ 
rections  in  the  treatment  of  these  chil¬ 
dren.”  A  court  would  not  accept  a  lay¬ 
man’s  judgment  even  on  so  obvious  a 
matter  as  extremely  bowed  legs,  because 
this  might  establish  a  precedent  which 
in  most  instances  would  work  badly.  A 
layman’s  opinion  in  such  a  case  as  this 
is  a  less  responsible  one  than  a  doctor’s, 
since  the  latter’s  professional  standing  is 
involved  in  his  statements.  Even  with 
a  physician’s  statement  “it  is  very  dif¬ 
ficult  to  make  such  neglect  the  basis  of  a 
case  in  court.”  The  father  supports  his 
family,  the  mother  gives  good  care  as 
she  understands  it.  The  court,  fearing 
that  doctors  may  disagree,  hesitates  to 


41 


SOCIAL  DIAGNOSIS 


2.  This  family  has  lived  for  six  years  in 
two  tiny  rooms  on  the  top  floor.  Al¬ 
though  their  tenement  rooms  are  sunny 
and  clean,  the  children  do  not  get  suffi¬ 
cient  exercise  or  air.  The  parents  refuse 
to  move,  as  the  rent  is  small. 


3.  A  year  and  a  half  after  having  been 
urged  to  have  the  two  younger  children 
examined,  the  mother  took  the  youngest 
child  to  the  hospital  and  promised  to 
bring  the  second  child.  Eight  months 
later  she  had  not  done  this. 


force  a  debatable  treatment  upon  well- 
meaning,  if  ignorant  parents.  One 
might  venture  to  predict  that  courts  will 
more  readily  consider  neglect  of  this  sort 
as  they  grow  inclined  to  take  common 
sense  risks  instead  of  resting  on  the  let¬ 
ter  of  precedent. 

2.  The  sunniness  of  the  tenement  and 
the  fact  that  the  mother  keeps  it  clean 
would  prevent  a  court  from  regarding 
these  cramped  quarters  as  evidence  of 
culpable  neglect.  Public  opinion  would 
not  uphold  the  court  in  making  an  issue 
over  home  conditions  that  were  not  con¬ 
siderably  below  the  ideal  held  by  social 
workers.  The  social  worker  often  for¬ 
gets  this. 

3.  "While  it  looks  as  if  the  family  had 
been  neglected  in  years  past  either  de¬ 
liberately  or  through  ignorance,  or  both, 
the  situation  today  is  not  clear/'  The 
oldest  child  is  still  in  the  hospital,  the 
youngest  has  received  hospital  care,  and 
the  mother  has  promised  to  take  the 
second  child  to  the  out-patient  depart¬ 
ment.  With  this  evidence  of  good  in¬ 
tentions,  a  doctor’s  statement  (see  1) 
would  be  necessary  to  satisfy  a  court  of 
present  neglect. 


Here  was  a  deadlock.  In  asking  court  action  on  the  ground  of 
parental  neglect  the  social  worker  was  in  effect  calling  upon  the 
court  to  accept  his  interpretation  of  the  evidence  as  establishing 
the  fact  of  neglect,  and  to  order  the  children  to  be  submitted  to 
physicians  for  treatment.  The  court,  on  the  other  hand,  as  inter¬ 
preted  by  the  society  to  protect  children,  would  require  the  physi¬ 
cian's  testimony  as  a  link  in  establishing  the  fact  of  neglect  and 
would  be  unlikely  to  act  until  the  social  worker  himself  had  done 
the  thing  he  was  asking  the  court  to  do;  namely,  confront  the  case 
with  a  doctor.  It  would  seem  to  a  layman  as  if  in  such  a  case  the 
court  might  safely  summon  the  parents  and  child  into  court,  admit 
the  child’s  bowed  legs  and  the  social  worker’s  efforts  to  persuade 

42 


THE  NATURE  AND  USES  OF  SOCIAL  EVIDENCE 


■  & 


the  family  as  evidence,  and  put  this  father  and  mother  on  proba¬ 
tion^  to  consult  any  reputable  doctor  they  chose. 
s'\t  is  clear,  then,  that  whereas  social  evidence  is  distinguished 
from  that  used  in  natural  science  by  an  actual  difference  in  the 
subject  matter,  it  differs  from  legal  evidence  not  in  the  sort  of  facts 
offered,  but  in  the  greater  degree  of  probative  value  required  by 
the  law  of  each  separate  item.  The  additional  testimony  which 
the  court  would  have  asked  in  the  instance  cited  was  not  different 
in  kind  from  what  the  social  worker  already  had. 

In  short,reocial  evidence  may  be  defined  as  consisting  of  any_..apd 
alljacts  as  To  person aLani-a  m i  1  v  history  which,  taken  together,  jn- 
dicate  the  natureTiCaS  difficulties  and  the  means 

•*>■  •  l  — '  '  *  V — )  .  ■" 


dom] 

hTch  1 


to  their  solution.]  Such  facts,  when  duly  tested  in  ways  that  fit 


the  uses  to  which  they  are  to  be  put,  will  influence,  as  suggested  in 
the  preceding  chapter,  the  diagnosis  of  physical  and  mental  dis¬ 
orders,  will  reveal  unrecognized  sources  of  disease,  will  change 
court  procedure  with  reference  to  certain  groups  of  defendants,  and 
will  modify  methods  in  the  school  class  room.  To  a  certain  extent 
social  evidence  is  already  exerting  this  influence,  but  the  demand 
for  such  evidence  is  likely  far  to  outstrip  the  supply  during  this 
next  decade. 


II.  THE  WIDER  USE  OF  SOCIAL  EVIDENCE 

Scattered  and  tentative  as  they  still  are,  the  signs  of  such  coming 
demand  are  nevertheless  unmistakable;  the  uses  of  social  evidence 
.  in  the  older  professions  are  beginning  to  multiply,  as  the  following 
illustrations  will  show: 

A  specialist  in  the  diagnosis  of  feeble-mindedness  committed  two  difficult  girls  to 
custodial  care,  largely  on  the  facts  supplied  him  from  first-hand  observations  by  a 
children’s  aid  society  as  to  the  characteristics  of  these  girls  and  of  their  families. 
The  “stream  pictures”  furnished  in  summaries  of  two  case  records,  covering  two 
years  in  one  instance  and  nine  in  the  other,  were  his  most  conclusive  evidence. 

The  nature  of  these  stream  pictures  may  be  gathered  from  Dr. 
W.  E.  Fernakf s  discussion  of  the  evidence  needed  by  the  psychi¬ 
atrist  for  making  a  diagnosis  of  mental  defect.  Some  of  this  evi¬ 
dence,  although  obtainable  by  social  workers,  is  of  course  medical  in 
character,  that  is,  delayed  dentition,  late  walking,  delayed  speech, 
a  history  of  convulsions  in  the  first  few  years  of  life,  the  presence 

43 


SOCIAL  DIAGNOSIS 


of  degenerative  stigmata.  Much  of  it,  however,  is  precisely  the 
slight  but  cumulative  evidence  which  social  workers  habitually 
gather  as  bearing  on  disabilities;  namely,  facts  of  family  and  per¬ 
sonal  history  with  special  reference  to  the  period  of  infancy  and 
early  childhood,  a  relatively  long  continuance  of  untidy  habits 
(of  childhood),  the  public  school  grade  in  relation  to  age,  inability 
on  the  part  of  the  patient  to  apply  himself  continuously  either  in 
school  or  in  any  other  occupation  without  constant  supervision. 
In  some  cases  with  only  slight  intellectual  defect,  the  inability  to 
“make  good”  socially  will  be  a  deciding  factor  in  the  diagnosis.1 

All  of  .thjs  information,  includixifr-thf^iied i,L5t'1?lTbuid  be  given 


in  the  history  of  a  client  which  the  social  word^is  preparing  to 

submit  to  a  psvchiatrist. 

.  • — 

The  contributions  of  social  work  to  medicine  are  not  confined  to 
the  diagnosis  of  feeble-mindedness.  As  we  have  seen  in  the  first 
chapter,/  medical  diagnosis  and  Jzenimmt  are  beginning  to  show 
the  influence  of  the  social  evidence  gathered  in  the  medical-social 
departments  of  hospitals  and  dispensaries. 

^"AVe  have  also  seen  in  the  discussion  ofTeginnings  that  the  chil¬ 
dren’s  courts  of  the  United  States  owe  their  existence  to  social 
workers.  These  courts  supplement  legal  evidence  by  social.  Not 
only  have  the  courts  comeTo  recognize  the  value  of  a  more  liberal 
inclusion  of  imperfectly  relevant  evidence  in  disposing  of  child 
offenders;  they  are  growing  to  feel  that  even  the  method  of  gather¬ 
ing  this  evidence  has  an  influence  upon  the  welfare  of  the  child. 
They  believe  that  such  investigation  should  be  inspired  not  by  the 
ambition  to  run  down  and  convict  a  criminal  but  by  a  desire  to 
learn  the  best  way  to  overcome  a  boy’s  or  girl’s  difficulties.  The 
need  of  modifying  in  these  courts  the  usual  legal  procedure  is  thus 
commented  upon  by  Flexner  and  Baldwin: 


The  best  interests  of  the  child  make  it  necessary  for  the  court  to  consider  hearsay 
and  other  evidence  of  a  more  or  less  informal  kind  which  would  ordinarily  under 
strict  rules  of  evidence  be  excluded.  It  is  of  the  utmost  importance  that  the  court 
should  avail  itself  of  just  the  kind  of  evidence  that  the  investigator  [the  probation 

1  Fernald,  Walter  E.,  M.  D.  (Superintendent  of  the  Massachusetts  School  for 
the  Feeble-minded,  Waverly,  Mass.):  The  Imbecile  with  Criminal  Instincts,  p.  745. 
American  Journal  of  Insanity,  Vol.  LXV,  No.  4,  April  1909,  pp.  731-749. 

See  also  questionnaire  regarding  a  Child  Possibly  Feeble-minded  in  this  volume. 
Chapter  XXVI 1. 


44 


THE  NATURE  AND  USES  OF  SOCIAL  EVIDENCE 


officer]  presents.  If  it  should  finally  be  determined  that  the  laws  as  drawn  do  not 
permit  the  introduction  of  such  evidence,  express  provision  should  be  inserted  in 
the  statutes  allowing  its  use.1 

Another  court  having  its  origin  in  needs  brought  to  light  by 
1  social  work  is  the  court  ofjJomestic  relations,  which  may  in  time 
be  merged  with  the  children's  court.  It  suffers  at  present  from 
inability  to  secure  and  use  the  necessary  social  evidence.  This  ex¬ 
periment,  like  many  others,  will  continue  to  fall  short  of  full  use¬ 
fulness  until  social  workers  develop  the  diagnostic  skill  that  will 
enable  them  to  offer  to  the  court  authenticated  and  pertinent  in¬ 
formation.  The  following  is  a  case  in  point: 

A  court  of  domestic  relations  sentenced  a  man  for  desertion  and  non-support  on 
the  testimony  of  his  wife.  The  wife  then  applied  to  a  charity  organization  society 
for  relief  for  herself  and  four  children.  The  district  secretary,  assuming  that  on  the 
face  of  it  this  convicted  man  was  good-for-nothing,  asked  her  committee  to  arrange 
for  assistance  to  the  family.  It  was  with  reluctance  that  the  secretary  at  the  sug¬ 
gestion  of  her  committee  agreed  to  make  what  she  regarded  as  a  superfluous  inves¬ 
tigation  of  the  man’s  side  of  the  story.  This  inquiry,  however,  brought  statements 
from  employers,  former  neighbors,  relatives,  etc.,  which  showed  that  the  trouble 
lay  not  with  the  man,  who  was  a  decent  enough  fellow,  but  with  the  woman,  who  was 
probably  mentally  unbalanced.  Instead  of  voting  relief,  therefore,  the  district 
committee  asked  the  judge -to  release  the  man. 

In  short,  the  secretary  in  question  would  hardly  have  been  quali¬ 
fied  to  persuade  a  court  of  the  helpfulness  of  social  evidence,  while 
she  herself  was  capable  of  treating  an  inference — that  as  to  the 
m^o's  character — as  if  it  were  an  evidential  fact. 

/  jMany  educators,  even  though  not  thinking  in  terms  of  social 
worE,  are  recognizing  their  need  of  obtaining  social  histories  of 
pupils  jindof^giving  differential  .Treatment  based  upon  them^  The 
social  worker's  method  they  sometimes  take  over  with  little  under¬ 
standing  of  its  details.  For  instance,  Madame  Montessori  in  her 
Pedagogical  Anthropology  makes  a  plea  for  differential  treatment 
of  pupils  and  gives  a  whole  chapter  to  the  question  of  securing  the 
biographical  history  of  the  pupil  and  of  his  antecedents;2  but  she 
apparently  has  little  conception  of  the  varying  reliability  of  the 

1  Flexner,  Bernard,  and  Baldwin,  Roger  N.:  Juvenile  Courts  and  Probation, 
p.  52.  New  York,  Century  Co.,  1914. 

2  Montessori,  Marie:  Pedagogical  Anthropology  (Translated  from  the  Italian 
by  Frederic  Taber  Cooper),  pp.  404-453.  New  York,  Frederick  A.  Stokes  Co.,  1913. 

45 


SOCIAL  DIAGNOSIS 


different  sources  from  which  such  social  evidence  must  be  had,  or 
of  the  tests  that  could  be  applied  to  assure  reliability, 

Stuart  Courtis,  of  the  New  Y or k  Commit tee  pjn  ScJioqL J-nqu ir y , 
who  starts  with  an  effort  to  test,  by  measurements  based  upon 
arithmetic  alone,  the  efficiency  of  school  and  children,  arrives  fin¬ 
ally  at  two  interesting  conclusionsTflTirst,  that  life  histories  alone 
can  make  plain  the  plavof  those  hidden  forces  which  are  constantly 
modifying  the  results  of  educational  effort;  and  second,  that  where 
marked  differenc.es.in  the  social  life  of  the  different  types  of  children 
exist,  .those^iijfarance.s  must  be  reflected  in  school  methojsT  For 
reasoning  cannot  be  taught  from  a  text  alone.  “  ReasorffTfg  is  a 
process  of  adjustment  to  a  situation,  and  only  as  children  have 
experienced  the  fundamental  characteristics  of  a  situation  can  they 
mtelligently  make  the  necessary  adjustments  to  it.”1 

The  beginnings  of  social  case  work  in  a  field  closely  allied  to 
education,  in  vocational  midance,  serve  to  illustrate  how,  in  the 
enthusiasm  of  promoting  a  new  discovery,  the  need  of  social  evi¬ 
dence  may  be  overlooked.  In  this  line  of  endeavor  (though  not  in 
some  others,  where  the  illustration  may  still  serve  as  a  warning) 
the  oversight  was  only  a  temporary  one.  The  first  volume  of  advice 
addressed  to  what  were  to  be  known  as  “vocational  counselors” 
gave  specimen  interviews  for  their  instruction.  One  of  these  is 
with  a  lad  of  nineteen  in  Boston  who  comes  for  vocational  guidance 
and  says  that  he  wants  to  be  a  physician.2  The  following  is  a  part 
of  the  counselor’s  printed  report: 


He  was  sickly  looking,  small,  thin,  hollow-cheeked,  with  listless  eye  and  expres¬ 
sionless  face.  He  did  not  smile  once  during  the  interview  of  more  than  an  hour. 
He  shook  hands  like  a  wet  stick:-  His  voice  was  husky  and  unpleasant,  and  his  con¬ 
versational  power,  aside  from  answering  direct  questions,  seemed  practically  limited 
to  “ss-uh,"  an  aspirate  “yes,  sir,"  consisting  of  a  prolonged  5  followed  by  a  non¬ 
vocal  uh,  made  by  suddenly  dropping  the  lower  jaw  and  exploding  the  breath  with¬ 
out  bringing  the  vocal  cords  into  action.  He  used  this  aspirate  “yes-sir”  constantly, 
to  indicate  assent,  or  that  he  heard  what  the  counselor  said.  He  had  been  through 
the  grammar  school  and  the  evening  high;  was  not  good  in  any  of  his  studies,  nor 
especially  interested  in  any.  His  memory  was  poor.  He  fell  down  on  all  the  tests 


1  Courtis,  Stuart  A.:  The  Courtis  Tests  in  Arithmetic  (Section  D  of  Subdivision 
I  of  Part  1 1  of  the  Report  on  Educational  Aspects  of  the  Public  School  Systems  of 
the  City  of  New  York),  pp.  1 50—1 55.  City  of  New  York,  191 1-12. 

2  Parsons,  Frank,  Ph.  D.:  Choosing  a  Vocation,  p.  1 14  sq.  Boston,  Houghton, 
Mifflin,  and  Co.,  1909. 

\ 


46 


THE  NATURE  AND  USES  OF  SOCIAL  EVIDENCE 


for  mental  power.  He  had  read  practically  nothing  outside  of  school  except  the 
newspapers.  He  had  no  resources  and  very  few  friends.  He  was  not  tidy  in  his 
appearance,  nor  in  any  way  attractive.  He  knew  nothing  about  a  doctor’s  life; 
not  even  that  he  might  have  to  get  up  any  time  in  the  middle  of  the  night,  or  that 
he  had  to  remember  books  full  of  symptoms  and  remedies. 

The  boy  had  no  enthusiasms,  interests,  or  ambitions  except  the  one  consuming 
ambition  to  be  something  that  people  would  respect,  and  he  thought  he  could  ac¬ 
complish  that  purpose  by  becoming  a  physician  more  easily  than  in  any  other  way. 

When  the  study  was  complete,  and  the  young  man’s  record  was  before  him,  the 
counselor  said: 

“Now  we  must  be  very  frank  with  each  other.  That  is  the  only  way  such  talks 
can  be  of  any  value.  You  want  me  to  tell  you  the  truth  just  as  I  see  it,  don’t  you? 
That’s  why  you  came  to  me,  isn’t  it, — not  for  flattery,  but  for  a  frank  talk  to  help 
you  understand  yourself  and  your  possibilities?’’ 

“When  the  study  was  complete !”  Psychologists  realize  now 
that  tests  of  memory,  like  most  other  mental  tests,  must  be  re¬ 
peated  to  eliminate  accidental  factors;  but  assuming  that  the  coun¬ 
selor  had  made  the  psychological  tests  with  care,  he  still  has  ignored 
many  factors,  which  though  not  measurable  by  tests  would  yet 
modify  the  social  diagnosis.  He  tells  the  boy  that  he  cannot  be  a 
doctor,  that  he  might  succeed  in  some  mechanical  or  manufactur¬ 
ing  industry,  that  he  must  cultivate  a  cordial  smile  by  speaking 
before  a  glass,  that  he  must  read  solid  books,  study  to  prepare  for 
citizenship,  and  so  on.  Such  unconstructive  vocational  guidance 
the  counselor  apparently  supposed  to  be  a  form  of  social  treatment. 
Had  he  used  his  opportunity  to  acquire  social  evidence  as  well  as 
psychological,  he  might  have  instituted  treatment  that  would  have 
struck  at  the  root  of  the  boy’s  difficulty.  Here  is  a  boy  who  has 
been  attending  the  evening  high  school  for  several  years.  Has  he 
been  employed  during  the  day;  if  so,  at  what?  Is  this  work  of  a 
kind  that  would  account,  in  part  at  least,  for  his  failure  as  a  stu¬ 
dent?  Are  there  removable  causes  not  only  for  his  lack  of  success 
but  for  his  physical  condition  as  well?  In  the  case  of  such  a  boy, 
should  not  a  medical  diagnosis  precede  vocational  advice?  What 
are  his  home  surroundings?  Have  his  parents  plans  for  him  or 
aptitudes  of  their  own  that  would  suggest  possibilities  in  him?  Are 
any  of  his  family  already  known  to  some  of  the  hundreds  of  social 
workers  in  Boston?1  If  so,  a  summary  of  this  social  work  experi¬ 
ence  might  be  suggestive.  The  book  containing  this  illustrative 

1  For  a  description  of  the  confidential  exchange  see  p.  303  sq. 

47 


SOCIAL  DIAGNOSIS 


interview  was  written  to  aid  vocational  counselors,  presumably 
busy  men.  Nevertheless  the  question  as  to  what  a  boy  is  to  do 
with  his  working  days  for  years  to  come  is  too  vital  a  one  for  such 
summary  disposal.  The  interview  here  quoted,  ignoring  the  pos¬ 
sible  aid  of  other  specialists,  professes  to  be  complete  in  itself, 
whereas  a  few  letters  and  telephone  messages  to  employers, 
teachers,  confidential  exchange  of  information,  and  the  boy's 
parents,  together  with  a  reference  to  a  competent  physician,  would 
have  brought  to  light  social  and  physical  factors  which  contributed 
to  the  boy's  ill  success,  and  would  have  indicated  how  to  remove 
them. 

The  counselor  dealt  with  symptoms  only.  He  assumed  that  an 
examination  of  the  boy  as  regarded  his  appearance,  speech,  and 
mental  reactions,  during  that  brief  cross-section  of  time,  would  give 
all  the  data  necessary  for  treatment.  Only  to  one  who  was  all-wise 
and  all-knowing  could  a  single  examination  have  been  thus  fruitful. 

Variations  of  these  same  ideas  crop  up  in  unexpected  places. 
Scientific  shop  management  has  accepted  the  principle  of  studying 
the  personal  traits  of  the  individual  workman  and  of  basing  his 
advancement  upon  such  study,  but  forTacFof  social  technique  its 
present  application  of  the  principle  is  often  too  crude  and  some¬ 
times  too  undemocratic  to  illustrate  our  theme. 

I-fc^/mild  sppm  that  social  evidence  is  beginning  to  receive  .recog¬ 
nition.  The  endeavors  of  social  workers  are  bringing  to  light  ways 
of  thinking  and  doing  that  prove  useful  in  quite  other  fields.  The 
fact  that  law,  medicine,  history,  and  psychology,  in  their  effort  to 
break  new  ground,  have  been  opening  the  same  vein  of  truth, 
shows  a  growing  demand  for  the  kind  of  data  that  social  practi¬ 
tioners  gather.  J  The  absence  of  any  generally  accepted  tests  of  the 
reliability  of  such  evidence,  however,  still  keeps  this  new  demand 
itself  ill  defined  and  unstandardized.  Personal  histories  which 
might  appear  sufficiently  authenticated  to  a  shop  manager  might 
strike  a  neurologist  as  inadequate  for  conclusions,  while  they  would 
certainly  be  open  to  objections  from  a  court.  Progress  on  the  social 
side  of  these  several  fields  of  endeavor  will  be  hastened  as  social 
workers  subject  their  own  experiences  to  a  more  critical  and 
searching  analysis. 

It  was  not  to  be  expected  that  industry,  or  education,  or  juris- 

48 


THE  NATURE  AND  USES  OF  SOCIAL  EVIDENCE 

prudence,  or  medical  science,  or  preventive  social  legislation  should 
wait,  before  they  developed  in  harmony  with  the  thought  of  today, 
until  the  arts  of  social  diagnosis  and  treatment  had  caught  up. 
All  of  these  went  forward  in  their  several  ways,  but  their  very 
advance  has  emphasized  the  need  of  skill  in  this  newer  art.  Tech¬ 
nique  has  not  occupied  the  attention  of  the  social  workers  them¬ 
selves  so  much  as  has  the  rapid  development  of  new  social  special¬ 
ties,  some  of  them  ill  considered,  perhaps,  but  all  following  inevit¬ 
ably  upon  that  flowering  of  social  ideals  in  this  country  which 
belongs  to  the  last  fifteen  years.  The  time  has  now  arrived  to  take 
fuller  advantage  of  these  new  developments. 


Attention  to  the  details  of  social  evidence  is  so  new  in  case  work 
that,  in  addition  to  the  comparing  of  case  work  experiences  at¬ 
tempted  in  Parts  1 1  and  1 1 1  of  this  book,  it  has  seemed  necessary 
to  seek  light  wherever  it  could  be  found.  Social  work  has  its  own 
approach  to  evidence,  but  wherever  men  of  first-rate  standing  in 
other  professions  have  discussed,  in  a  way  not  too  technical  to  be 
understood  by  the  layman,  this  subject  of  evidence,  it  is  worth  our 
while  to  give  attention.  As  will  be  seen  from  the  Bibliography,1 
free  use  will  be  made  in  these  pages  of  the  remarkable  contributions 
of  Professor  Hans  Gross  to  crjuninal  jurisprudence,  of  Professor 
J.  H.  Wigmore’s  Principles  of  Judicial  Proof,  and  of  James  B. 
Thayer’s  Preliminary  Treatise  on  Evidence  at  the  Common  Law. 
Dr.  S.  Weir  Mitchell,  Dr.  Paul  Dubois,  Dr.  Richard  C.  Cabot,  and 
Dr.  S.  J.  Meltzer  have  all  written  about  medical  diagnosis  in  a  way 
which  is  suggestive  and  stimulating  even  to  those  who  have  had 
no  medical  training.  The  modern  approach  to  the  study  of  history 
is  clearly  set  forth  in  a  book  that  case  workers  should  all  read,  the 
admirable  Introduction  to  the  Study  of  History  by  Langlois  and 
Seignobos.  Alfred  Sidgwick’s  books  on  logic  have  also  been  con¬ 
sulted  in  the  treatment  of  the  subject  of  inferences.  From  applied 
psychology,  apart  from  the  measuring  scales  now  in  use,  we  are 
likely  to  receive  in  the  future  contributions  which  may,  in  many 

Eportant  particulars,  modify  the  methods  described  in  this  book, 
itil^  caseworkers  know  mom  about  psychology,  however,  than 
they  now  do,  they  will  not  be  able  even  to  formulatemeTF  heeds  in 

49 


4 


SOCIAL  DIAGNOSIS 


a  way  to  command  the  psychologist’s atteotion  J  There  are,  then, 
tasks  of  absorbing  interest  awaiting  the  social  case  workers  of  this 
and  the  next  generation. 


SUMMARY  OF  THIS  CHAPTER 

1.  Social  evidence  may  be  defined  as  consisting  of  all  facts  as  to  personal  or 
5  family  history  which,  taken  together,  indicate  the  nature  of  a  given  client’s  social 

difficulties  and  the  means  to  their  solution. 

2.  Depending  as  it  does  less  upon  conspicuous  acts  than  upon  a  trend  of  behavior, 
social  evidence  often  consists  of  a  series  of  facts  any  one  of  which  would  have  slight 
probative  value,  but  which,  added  together,  have  a  cumulative  effect. 

3.  Social  evidence  differs  from  legal  evidence  in  that  it  is  more  inclusive  and  that 
the  questions  at  issue  are  more  complex.  For  these  reasons,  careful  scrutiny  of  the 
reliability  of  each  item  of  such  evidence  is  all  the  more  necessary. 

4.  The  usefulness  of  social  evidence  outside  of  what  is  usually  described  as  social 
work  has  been  demonstrated  in  the  diagnosis  of  physical  and  mental  disorders,  in 
the  procedure  of  courts  with  certain  groups  of  defendants,  in  the  differential  treat¬ 
ment  of  children  in  the  schools,  and  in  their  vocational  guidance.  A.S  tests  of  its 
reliability  are  better  formulated  and  more  generally  accepted,  it  will  be  put  to  still- 
wider  use. 


5.  Social  work  has  its  own  approach  to  evidence,  but  as  regards  the  testing  of 
its  evidential  material  it  has  much  to  learn  from  law,  medicine,  history,  logic,  and 
psychology. 


CHAPTER  III 


DEFINITIONS  BEARING  UPON  EVIDENCE 

THE  first  interview  with  one  needing  treatment,  the  early 
contacts  with  his  immediate  family,  the  consultations  with 
those  outside  his  family  who  may  give  insight  or  co-opera¬ 
tion,  the  examination  of  any  documents  bearing  upon  his  problem, 
the  later  correlation  of  these  separate  items — all  these  processes  of 
social  case  work  are  steps  in  what  we  hope  will  be  a  helpful  course 
of  action.  They  lead  up  through  social  diagnosis  to  a  plan  of 
treatment.  The  relation  of  diagnosis  to  this  practical  end  cannot 
be  too  much  insisted  upon.  Before  turning  to  the  discussion  of 
this  relation  in  present-day  case  work  practice,  however,  it  is 
necessary,  even  at  the  risk  of  some  repetition,  to  prepare  the  way 
for  the  more  concrete  material  which  is  to  follow  by  giving  at  this 
point  a  few  formal  definitions. 


I.  CERTAIN  TERMS  FREQUENTLY  USED 
1.  Diagnosis*.  The  use  of  the  word  diagnosis  is  not  restricted  to 
medical  case  work;  it  means  in  zoology  and  botany,  for  example, 
“ a  brief,  precise,  and  exclusively  pertinent  definition.”  /  In  social 
diagnosis  there  is  the  altempl-^  a  definition  as_ 

possible  of  the  social  situation  and 


Investigation,  or  the  gathering  of  evidence,  begins  the  process,  the 
critical  examination  and  comparison  of  evidencejfolloa^and-h^t 
comStflriTefp relation  and  the  defmtfion  of  TKeTsocial  difficulty. J 
In  common  use,  case  workers  often  call  all  ofthis  “an  investiga¬ 
tion,”  but,  as  their  besetting  sin  is  to  slur  over  the  processes  of 
comparison  and  interpretation  and  to  overemphasize  the  gathering 
of  items  of  evidence,  there  is  an  educational  advantage  in  using 
for  the  whole  process  the  word  which  describes  more  especially  the 
end  of  the  process.  Investigation  enters  into  diagnosis,  it  enters 

1  See  fuller  discussion  in  Chapter  XVI 1 1,  Comparison  and  Interpretation,  p.  357. 

51 


SOCIAL  DIAGNOSIS 


into  the  laborious  and  learned  seeking  for  truth  which  deserves  to 
be  termed  social  research,  and  it  fQfjms  an  important  part  of  the 
manyjinquiries  into  social  conditions  which  do  not  meet  the  exact¬ 
ing  requirements  of  research,  but  which  may  properly  be  described 
as  |s ocial  investigations.  While  the  word  investigation  is  used  in 
all  these  forms  of  social  inquiry,  the  place  which  the  process  itself 
fills  in  social  diagnosis,  however  necessary,  is  subordinate.  An 
added  advantage  in  the  word  diagnosis  is  that  its  use  in  medicine 
has  given  it  the  valuable  connotation  of  a  time  limit.  A  diagnosis 
may  be  and  often  must  be  revised,  of  course,  but  a  relatively  in¬ 
elastic  time  limit,  together  with  the  beneficent  action  always  in 
view,  constitute  the  controlling  conditions  of  diagnosis  in  social 
work.  x-v 

2.  Witnesses.  In  so  far  as  personal -statements  rather  than 
documents  are  drawnjlP^  for  its  evidence, 

case  work  deals  directly  with  witnesses]  ThesenmstnoTBe  confused 
with  trained  observers.  The  latter  vftTrd  belongs  to  natural  science; 
the  former  is  primarily  a  law  term.  The  observer  is  trained  to 
accuracy,  is  on  theJookout  for  facts  tending  to  uphold  or  discredit 


heJo( 

some  hypothesis  ;(j;he  witness  reports^ybatTie  has  seen  or  heard 
incidentally  in  the  course  of  his  daily  life,.  The  observer  uses  con¬ 
trolled  experimentation  as  his  method,"  approaching  his  subject 
with  impersonal  detachment;  whereas Itjie  witness  has  no  method, 
is  liable  to  personal  bias,  and  is  accurate  or  not  according  to  his 
native  powers  of  observation  and  memory.  Rarely  is  the  witness 
whose  testimony  is  recorded  in  the  interviews  of  social  records  an 
observer  in  the  scientific  sense.1 

p  Case  records  sometimes  ask  for  and  set  forth  the  statements  of 
references.  The  word  describes  those  who  vouch  for  another! 
The  slackness  of  its  meaning  is  reflected  in  the  quality  of  evidence 
secured,  this  frequently  amounting  to  no  more  than  the  “  vouching” 
of  the  early  days  of  English  law  courts,  when  almost  the  only  evi¬ 
dence  sought  was  that  of  witnesses  ,who  swore  under  oath  to  the 
innocence  or  guilt  of  the  defendant.  I  Social  case  workers  are  some¬ 
times  content  with  equally  bare  testimony  as  to  a  man’s  sobriety 
and  industry  even  from  references  who  are  presumably  in  command 
of  facts  which  would  throw  light  upon  the  cause  of  his  need  and 
1  See  Chapter  II,  Nature  and  Uses  of  Social  Evidence,  p.  40. 

52 


DEFINITIONS  BEARING  UPON  EVIDENCE 


upon  possible  methods  of  removing  itj  For  example,  a  clergyman 
who  refers  a  family  for  aid  with  the  statement  that  he  has  known 
the  man  for  some  time  and  can  vouch  for  him,  must  be  in  possession 
of  some  definite  facts  about  the  man  in  questiim^which  would  prove 
helpful  in  planning  treatment  for  the  family.  [The  initial  difficulty 
in  case  work  is  always  that  of  getting  at  facts  which  are  ample  and 
pertinent^ 

3.  Fact.  What  do  we  mean  by  the  word  fact?  It  is  not  limited 
to  the  tangible,  as  James  Bradley  Thayer  has  pointed  out.1 
Thoughts  and  events  are  facts.  (The  question  whether  a  thing  be 


fact  or  not  is  the  question  whether  or  not  it  can  be  affirmed  with 
certainty,]  Social  workers  do  not  always  bother  to  ask  themselves 
whether  the  statements  they  make  can  be  affirmed  with  certainty. 
It  is  no  unusual  thing,  for  example,  to  read  in  a  social  case  record 
the  entry,  “Gave  the  inquiring  agency  all  the  facts  in  this  case,,*’ 
or  “Asked  the  committee  what  they  would  advise  in  view  of  the 
facts  in  our  possession,”  when  not  a  single  fact  or  only  a  few  irrel¬ 
evant  ones  had  been  obtained.  Records  even  show  instances  of 
letters  having  been  sent  to  other  states  or  countries  suggesting 
action  on  some  family  situation  and  presenting  “the  following 
facts,”  when  the  alleged  facts  are  no  more  than  unverified  state¬ 
ments  intermingled  with  the  opinions  and  conjectures  of  the  writer. 
The  following  is  a  case  in  point: 


A  case  work  agency  wrote  this  answer  to  an  agency  in  another  state:  “The  Aid 
Society  here  in  X  has  known  the  Y  family  since  January,  1910,  and  we  have  con¬ 
sulted  their  record  and  also  have  looked  up  two  references  given  in  your  letter.  A 
year  ago  the  Aid  Society  looked  up  Mr.  Y’s  work  references  and  his  employers  all 
speak  ill  of  him.  They  say  he  was  a  shifty  fellow  who  drank  heavily,  did  unsatis¬ 
factory  work,  was  untruthful,  and  has  even  been  accused  of  stealing.  We  have 
heard  that  Mr.  Y  has  at  different  times  gone  under  assumed  names.  We  believe 
that  Mrs.  Y  is  of  a  much  better  sort  than  her  husband,  though  we  have  only  her 
friends’  word  for  it.” 

The  “facts”  in  this  case  were  that  the  Aid  Society,  although  its  acquaintance 
with  the  family  began  in  1910,  had  not  kept  track  of  them  all  that  while,  but  had 
only  the  intermittent  knowledge  accompanying  two  appeals  for  relief.  The  em¬ 
ployers  who  “all  speak  ill  of  him”  consisted  of  but  one  employer  with  whom  the 
man  worked  a  year  and  whom  he  left  of  his  own  accord.  This  one  employer,  how¬ 
ever,  did  speak  of  the  man  as  shifty.  The  testimony  as  to  drink  came  from  a  land¬ 
lady,  not  an  employer,  while  the  accusation  of  theft  was  made  by  the  woman’s 

1  Preliminary  Treatise  on  Evidence,  p.  19 1. 

53 


SOCIAL  DIAGNOSIS 


brother,  the  theft  being  of  clothes  loaned  by  this  brother  which  the  man  wore  when 
he  left  his  relative’s  house  owing  money  for  board.  Mr.  Y  had  used  no  alias  but  the 
last  name  of  his  stepfather,  and  the  alleged  reason  for  his  doing  this  had  not  been 
verified.  The  last  sentence  is  frankly  a  mere  expression  of  opinion. 

However  near  the  truth  may  be  the  general  impression  conveyed 
by  this  letter,  since  the  statements  taken  one  by  one  could  not  be 
“affirmed  with  certainty,”  the  agency  to  which  this  information 
was  sent  could  not,  on  such  a  basis,  plan  treatment  that  would 
strike  at  the  root  of  the  trouble. 

Every  body  of  organized  knowledge  and  skill  advances  in  accord 
with  its  command  of  facts  relevant  to  its  aims.  To  take  an  in¬ 
stance  far  afield:  An  advertiser,  writing  in  Printers  Ink,  says  that 
“  Many  an  advertisement  contains  little  arid  spots,  each  of  which 
represents  a  fact  which  the  copy  writer  didn't  know,  and  the  lack 
of  which  had  to  be  glossed  over  with  language.”  This  sentence 
might  have  been  written  about  many  a  social  case  record,  though 
it?would  have  fitted  the  record  of  ten  years  ago  still  better. 

The  gathering  of  ,^facts  jn  any  field  of  interest  is  made-difficult 
first  by  faulty  recollection  or Jay  i hexpert-Gf-pretudieed-observation 
on  the  part  of  persons  giving  testimony,  and  second  by  a  confusion 
between  the  facts  themselves  and  inferences  drawn  from  them  on 
the  part  either  of  witnesses-orpin  the  special  realm  oTour  study, 
of  social  workers.!, 

The  confusion  between  the  fact  itself,  even  when  accurately 
observed,  and  the  inferences  drawn  by  the  observer  is  well  illus¬ 
trated  by  Dr.  S.  J.  Meltzer: 

A  physician  has  given  ...  let  us  say,  five  grains  of  phenacetin  to  a  pneu¬ 
monia  patient  with  a  temperature  of  105°  F.  on  the  seventh  day  of  the  disease. 
The  temperature  dropped  to  normal  and  the  patient  got  well.  The  non-critical 
physician  might  record  it  as  a  fact  that  five  grains  of  phenacetin  reduced  a  tempera¬ 
ture  of  105°  F.  to  normal  and  cured  the  patient.  But  this  was  not  a  fact;  it  was  a 
conclusion  [an  inference]  and  a  wrong  one  .  .  .  ;  the  cure  was  accomplished  by 

the  crisis  which  accidentally  set  in  after  the  giving  of  the  phenacetin.  Possibly  the 
reduction  of  the  fever  was  essentially  also  due  to  the  crisis.  What  the  physician 
actually  observed  were  the  three  facts  following  one  another,  (1)  the  giving  of  the 
phenacetin,  (2)  the  reduction  of  the  fever,  and  (3)  the  recovery  of  the  patient.  The 
connecting  of  the  three  facts  was  ...  an  act  different  and  separate  from  the 
facts  he  actually  observed.1 

1  “Ideas  and  Ideals  in  Medicine,”  in  Journal  of  the  American  Medical  Associa¬ 
tion,  May  16,  1908,  p.  1577  sq. 


54 


DEFINITIONS  BEARING  UPON  EVIDENCE 


An  American  statesman  who  justified  a  public  act  by  the  asser¬ 
tion  that  he  “  dealt  with  the  facts,”  was  criticised  in  a  leading 
article  of  the  New  York  Evening  Post  as  follows: 

The  assumption  is  that  to  ascertain  facts  and  act  upon  them  is  the  easiest  thing 
in  the  world.  Principles  may  be  cloudy  and  ideals  escape  us,  but  when  you  have  a 
big,  brutal  set  of  facts  before  you,  how  can  you  go  wrong?  Everybody  who  stops 
to  think,  however,  knows  that  dealing  with  facts  is  one  of  the  most  delicate  opera¬ 
tions  of  the  human  mind.  There  is,  in  the  first  place,  the  enormous  difficulty  of 
making  sure  that  the  facts  are  as  stated  to  us  by  others.  Next  comes  the  arduous 
duty  of  avoiding  that  “instinctive  theorizing,”  whence  the  fact  looks  to  the  eye  as 
the  eye  likes  the  look.  And  in  the  end  there  is  the  obligation  to  decide  what  is  the 
correct  inference  to  be  drawn  from  the  facts,  once  granted  that  they  are  clearly 
established.  To  say  in  defence  of  challenged  conduct,  “I  dealt  with  the  facts,” 
is  no  defence  at  all  unless  you  are  able  to  show  that  you  first  got  your  facts  straight 
and  then  dealt  with  them  properly.1 


Thus  at  the  threshold  of  our  consideration  of  social  evidence, 
the  duty  confronts  us  of  making  sure  what  are  facts  in  a  client's 
situation.  [Evidence  which  is  reliable  and  which  is  sufficient  in 
amount  and  cogency  is  tlfe^fTrst  requisite  for  searching  diagnosis; 
the  second  is  clear  reasoning  to_ inferences  that  shall  further  aur 
purpose.  The  use  of  inference .  then,  the  act  of  passing  from  some 
fact,  belief— or  judgment  about  a  matter  bearing,  on  the  client’s 
difficulty  to  a  further  judgment,  is  an  important  part  of  diagnostic 
Ykill.jlts  risks  in  case  work,  and  its  relation  to  assumptions  and 
hypotheses  are  discussed  at  length  in  a  later  chapter.2 

Evidence.  The  words  evidence  and  proof  are  often  confused. 
^ Joidence  is  the  ultimate  fact  or  facts  offered  as  a  basis  for  infer¬ 
ence;  inference ,  a  part  of  the  process  of  reasoning  from  this  fad 
or  facts  to  another — unknown — fact.;  while  proof Js  the  result  of 
the  reasoningTJn  social  diagnosis,  the  kinds  of  evidence  available, 
being  largeI)Ttestimonial  in  character,  can  of  course  never  show  a 
probative  value  equal  to  that  of  facts  in  the  exact  sciences.  [All 
that  is  possible  for  us  is  to  obtain  proof  that  amounts  to  a  reason¬ 
able  certainty.]  Social  treatment  is  even  more  lacking  in  precision 
than  the  treatment  of  disease,  of  which  Dr.  Meltzer  says  that  every 
treatment  is  an  experiment.  This  is  true  partly  because  social 
work  has  as  yet  amassed  but  a  small  body  of  experience,  partly 
because  its  treatment  demands  for  success  an  understanding  of 

1  New  York  Evening  Post ,  August  19,  191 1.  2  See  Chapter  V,  Inferences. 

55 


SOCIAL  DIAGNOSIS 


“  characterology,”  for  which  no  satisfactory  body  of  data  yet 
exists,  but  most  of  all  because,  for  the  social  case  worker,  the  facts 
having  a  possible  bearing  upon  diagnosis  and  treatment  are  so 
numerous  that  he  can  never  be  sure  that  some  fact  which  he  has 
failed  to  get  would  not  alter  the  whole  face  of  a  situation.  He  can, 
however,  partially  offset  these  handicaps  by  being  on  the  lookout 
for  the  special  liability  to  error  characteristic  of  each  type  of  evi¬ 
dence  used  in  his  investigations. 

II.  TYPES  OF  EVIDENCE 

Distinctions  have  been  made  by  the  law  that  will  be  of  some 
service  to  us  here,  although  it  would  be  easy  to  exaggerate  their 
value.  Evidence  in  the  law  is  used  to  ascertain  the  existence  of  a 
particular  disputed  fact;  in  social  work,  as  already  indicated,  the 
problem  is  much  less  simple.  Nevertheless,  since  case  work  shares 
with  the  law  the  risks  and  the  advantages  that  come  from  a  depen¬ 
dence  upon  testimony  for  the  bases  of  action,  the  legal  classifica¬ 
tions  of  evidence  should  be  kept  in  mind.1 

(The  kinds  of  evidence  presented^  courts  may  be  divided  into 
real,  testimonial,  and  circumstantial.)  There  are  many  other  classi¬ 
fications,  but  they  are  not  of  general  application;  they  refer  to 
some  special  danger  or  weakness  of  evidence  as  offered  in  courts, 
for  the  sake  of  which  a  rule  of  caution  has  been  established.  These 
three  kinds  of  evidence  differ  in  the  ways  in  which  we  make  our 
inferences  from  them;  in  real  evidence  no  inference  is  needed; 
in  testimonial  evidence  the  basis  of  our  inference  is  a  human  asser¬ 
tion;  in  circumstantial  evidence  the  basis  of  an  inference  is  any¬ 
thing  whatever  except  a  direct  human  assertion.  This  may  not  seem 
clear,  but  the  explanations  which  follow  should  make  it  so,  and  the 
distinctions  made  are  important  enough  to  be  studied  closely. 

\  Real  Evidence.  „  Jn  real  evidence  the  very  fact  at  issue  is 
presented  to  our  senses^)  The  classic  instance  in  the  law  is  that  of 
the  tailor  ancThis  customer  who  disagree  as  to  the  fit  of  a  coat. 
The  tailor  sues,  the  customer  wears  the  coat  duringjdie  trial,  and 
the  jury  sees  for  itself  whether  the  coat  fits  or  not.2|  Real  evidence 

1  For  suggestions  and  criticism  in  this  part  of  the  chapter  the  author  would  make 
grateful  acknowledgment  to  Professor  J.  H.  Wigmore,  Dean  of  Northwestern 
University  Law  School. 

2  Thayer’s  Preliminary  Treatise  on  Evidence,  p.  263. 

56 


DEFINITIONS  BEARING  UPON  EVIDENCE 


may  become  the  basis  of  an  inference  and  usually  does.  )  Thus,  a 
person  is  seen  to  be  of  a  certain  size  and  complexion,  and  to  have 
a  certain  cast  of  features.  These  are  real  evidence  as  to  his  appear¬ 
ance,  from  which  we  may  infer  that  he  is  of  a  certain  age.1 

In  social  case  work,  real  evidence  is  any  item  of  evidence  had 
by  first-hand  inspection.  LThe  appearance  of  a  client’s  home  is 
real  evidence  as  to  the  conditions  under  which  he  lives;  the  meal 
on  the  table  is  real  evidence  that  his  family  is  not  without  food; 
and  so  on.]  When,  however,  the  case  worker  who  makes  these  in¬ 
spections  reports  them  to  others — to  case  supervisors  or  commit¬ 
tees,  for  example— The  evidence  which  was  “real”  to  him  is  testi¬ 
monial  to  them,  as  it  comes  to  them  on  the  assertion  of  the  worker.) 

2.] Testimonial  Evidence.  This  is  the  assertions  of  human 
beings.  There  is  an  important  distinction  here  for  the  case  worker 
between  the  testimonial  evidence  of  one  who  says  he  saw  or  heard 
the  supposed  fact  himself,  and  that  of  one  who  asserts  it  only  from 
what  others  have  told  him.  The  latter  is  called  hearsay  evidence. 
As  a  statement  is  passed  along  from  one  to  another  it  is  very  easy 
for  error  to  creep  in.  In  court,  therefore,  the  first  question  is, 
Did  you  see  or  hear  this  affair  yourself?  And  if  the  witness  says, 
No,  Mrs.  Jones  told  me,  then  the  judge  says,  Send  for  Mrs.  Jones, 
and  we  will  ask  her  to  tell  us  whether  she  saw  it;  and  so  on,  until 
they  find  some  first-hand  observer. 

|  The  social  worker  and  the  historian  cannot  and  need  not  reject 
an  item  of  hearsay  evidence,  as  the  court  does;  but  (i)  they  should 
be  cautious  in  relying  upon  it,  and  (2)  they  should,  if  possible, 
probe  back  until  they  find  an  original  observer. ;  Few  things  would 
strengthen  social  diagnosis  more  effectively  than  the  habit  of  dis¬ 
covering,  in  interviews  with  witnesses,  the  extent  to  which  their 
assertions  are  founded  on  observations  or  on  mere  rumor.  “An 
event  is  attested  three  times  by  three  chroniclers,”  says  Langlois, 
“  but  these  three  attestations,  which  agree  so  admirably,  are  really 
only  one,  if  it  is  ascertained  that  two  of  the  three  chroniclers  copied 
the  third,  or  that  the  three  parallel  accounts  have  been  drawn  from 
one  and  the  same  source.”2 


1  See  Wigmore,  J.  H.:  A  Treatise  on  the  System  of  Evidence  in  Trials  at  Common 
Law,  Vol.  II,  Sec.  1150.  Boston,  Little,  Brown,  and  Co.,  1904. 

2  An  Introduction  to  the  Study  of  History,  p.  94. 

57 


SOCIAL  DIAGNOSIS 


The  following  illustrations  of  the  risks  in  hearsay  evidence  are 
taken  chiefly  from  our  reading  of  social  case  records. 

L.  H.  Levin  of  the  Federated  Jewish  Charities  of  Baltimore  tells  of  one  case 
treatment  in  which  it  was  necessary  to  consult  a  merchant  about  a  former  employe. 
The  merchant  answered  by  quoting  the  report  of  his  manager  that  the  man  was  list¬ 
less,  tardy,  and  inclined  to  shirk  work.  Fortunately  the  manager  was  seen  for  fur¬ 
ther  details,  and  was  found  to  base  his  opinion  solely  upon  the  employe’s  tendency 
to  come  late  and  leave  his  work  early.  He  added  that  the  reason  given  by  the  work¬ 
man  was  that  he  must  take  care  of  his  home.  The  social  worker  found  that  the 
home  consisted  of  a  sick  wife  and  a  number  of  helpless  children,  and  that  the  hus¬ 
band  and  father  felt  the  imperative  necessity  of  caring  for  them. 

[Neither  manager  nor  merchant  intended  to  deceive.  The  manager’s  report, 
however,  because  first-hand,  showed  more  clearly  than  the  merchant’s  what  was 
fact  and  what  inference,  and  was  therefore  easier  to  reconcile  with  the  other  evidence 
obtained  by  the  social  worker.] 

The  parents  of  a  baby  under  treatment  in  a  dispensary  were  boarding  with  a 
friend.  A  milk  station  nurse  who  was  visiting  this  friend’s  family  reported  to  the 
dispensary  that  the  friend’s  children  had  syphilis,  whereupon  the  dispensary  visitor 
proceeded  at  once  to  advise  the  use  of  separate  towels,  dishes,  etc.  She  then  looked 
up  the  medical  record  of  the  boarding  house  keeper’s  children  and  found  that  the 
trouble  was  not  syphilis  but  scabies.  The  milk  station  nurse  had  secured  her  in¬ 
formation  from  the  mother  of  these  children.  The  original  source  for  medical 
information,  in  other  words,  is  the  doctor  or  his  record,  and  not  even  a  layman  so 
near  to  the  situation  as  the  patients’  mother. 

A  girl  was  brought  late  at  night  to  a  hospital  by  a  policeman.  When  her  land¬ 
lady  was  seen  the  next  day  by  a  visitor  from  the  medical-social  department  of  the 
hospital  she  stated  that  the  girl  had  been  picked  up  on  the  street  in  an  intoxicated 
condition,  and  that  the  policeman  who  found  her  had  said  she  was  a  “tough  lot.’’ 
At  the  police  station,  however,  the  patrolman  said  that  he  had  never  seen  the  girl 
until  he  discovered  her  in  an  unconscious  condition,  and  that,  so  far  as  he  knew, 
she  was  not  intoxicated.  Two  physicians  reported  that  the  girl  had  heart  attacks. 
The  landlady  was  a  hearsay  source  as  to  the  girl’s  condition  when  picked  up;  the 
policeman  a  first-hand  source  as  regards  his  own  experiences  with  the  girl;  the 
doctors  who  had  made  a  physical  examination  were  the  only  first-hand  sources  as 
regards  her  physical  condition. 

A  case  worker  supplies  the  following  example  of  hearsay  evidence  from  recent 
experience:  A  neighbor  said  of  Mrs.  B  that  she  neglected  her  little  girl  and  had  been 
ordered  by  the  school  to  cut  off  the  child’s  hair.  The  inference  which  the  investi¬ 
gator  was  intended  to  make  and  did  make  was — vermin.  Inquiry  at  the  school, 
however,  showed  that  the  child’s  hair  had  been  cut  off  because  of  a  rash.  On  another 
occasion  the  brother-in-law  of  this  same  client  reported  that  the  clinic  nurse  had 
said  in  a  way  that  made  it  sound  detrimental  that  she  was  “through  with  Mrs. 
B.’’  Inquiry  showed  that  this  nurse,  in  attempting  to  get  the  little  girl  into  a  pre¬ 
ventorium,  had  failed  repeatedly  to  find  Mrs.  B  at  home  (the  woman  was  away  at 

58 


DEFINITIONS  BEARING  UPON  EVIDENCE 


her  work  of  washing  and  ironing),  and  had  remarked  that  she  would  give  up  trying 
to  find  her. 

The  jeporter  of  this  case,  who  is  a  graduate  of  a  law  school,  feels 
that 'ijiany  social  case  records  show  a  failure  to  recognize  the  burden 
of  proof  as  resting  on  the  one  who  attacks  a  client’s  character,  and 
even  a  tendency  on  the  part  of  some  case  workers  to  accept  with¬ 
out  scrutiny  any  bit  of  unfavorable  testimony  that  may  help  them 
to  classify  clients  more  readily!]  The  rule  of  law  which  requires  that 
the  best  evidence  procurable  shall  be  produced  would,  in  her 
opinion,  be  a  safeguard.  Moreover,  the  social  records  that  had 
come  to  her  notice  did  not  show  that  in  weighing  evidence  allow¬ 
ance  had  been  made  for  prejudice  where  it  undoubtedly  existed. 
Prejudice  or  bias  in  witnesses  is  one  of  the  things  for  which  to  cul¬ 
tivate  a  keen  eye,  as  will  appear  in  the  discussion  of  Testimonial 
Evidence  in  the  next  chapter. 

i$.  Circumstantial  Evidence.  This  is  the  catch-all;  it  includes 
everything  which  is  not  the  direct  assertion  of  a  human  being.  By 
“direct  assertion”  is  here  meant  one  which  if  true  would  estab¬ 
lish  the  point  immediately  at  issue;  whereas  an  indirect  assertion 
— indirect  evidence  of  any  kind,  in  fact — merely  asserts^jpme  other 
fact  which,  in  turn,  tends  to  establish  the  point  at  issue., 

^  Suppose  the  point  to  be  determined  in  a  given  case  is  whether 
a  husband  feels  affection  for  his  family — a  question  which  is  of 
practical  importance  sometimes  in  case  decisions.  If  the  wife 
states  that  her  husband  does  not  care  for  her  and  their  children, 
she  is  giving  direct  testimonial  evidence.  She  may  be  mistaken  or 
she  may  misrepresent,  but  the  assertion  bears  directly  upon  the 
issue,  and  the  only  risks  involved  in  accepting  her  evidence  as 
proof  are  the  risks  involved  in  judging  her  competence  and  her 
bias.  When,  however,  she  names  certain  cumulative  circumstances 
from  which  might  be  inferred  the  state  of  the  man’s  affections; 
when  she  says  that  he  gives  her  $ 6.00  a  week  out  of  $22,  that  he 
spends  over  half  of  his  leisure  time  away  from  home,  that  he  is 
irritable  when  he  does  appear  there,  etc.,  these  statements,  which 
would  be  direct  testimony  as  to  his  habits,  are  only  indirect  testi¬ 
mony  as  to  his  indifference.  Now  this  indirect  testimony  is  subject 
to  the  same  tests  of  competence  and  fcjas  as  the  wife’s  direct  testi¬ 
mony,  both  being  the  assertions  of  a  human  being.  But  to  the 

59 

\ 


1 


SOCIAL  DIAGNOSIS 


inferences  drawn  from  the  former  additional  tests  must  be  applied; 
these  assertions  of  fact,  if  believed,  become  the  bases  of  an  infer¬ 
ence  to  another  fact.  We  must  ask:  Do  they,  taken  together, 
fairly  indicate  the  thing  inferred?  Do  the  meager  allowance,  the 
frequent  absences,  and  the  irritability — granting  all  to  be  true — 
really  mean  what  the  wife  asserts  that  they  mean?  Are  any  other 
explanations  possible?  If  they  are,  it  is  the  duty  of  the  case  worker 
to  seek  for  them. 

Note  in  the  foregoing  the  cumulative  effect  of  adding  item  to 
item  of  indirect  evidence,  each  a  comparatively  weak  basis  of  in¬ 
ference  itself,  but  gaining  in  cogency  with  every  circumstance 
added.  [Circumstantial  evidence^  always  indirect,  is  characteris¬ 
tically  cumulative?  Moreover,  |any  fact  in  the  material  universe 
or  in  the  mind  £>f  man  may  become?  the  basis  from  which  some  other 
fact  is  inferred.  The  trustworthiness  of  this  indirect  evidence, 
apart  from  the  bias  and  competence  of  the  witness  through 
whom  it  may  have  come,  depends  upon  a  set  of  considerations 
which  vary  with  the  nature  of  the  subject  matter — for  ex¬ 
ample,  electric  wires,  coal,  medicine,  cooking  utensils,  sewer  gas; 
whereas  the  trustworthiness  of  direct  evidence  depends  upon  cer¬ 
tain  human  traits  possessed  in  varying  degrees  by  all  witnesses, 
such  as  honesty,  bias,  attention,  memory,  suggestibility,  etc. 
The  relation  of  these  traits  to  evidence  will  be  discussed  in  the  next 
chapter. 

Despite  the  difficulty  of  drawing  correct  inferences  from  circum¬ 
stantial  evidence,  it  has  the  advantage  over  direct  testimonial 
evidence  that  the  inference  does  not  depend  upon  the  elusive  per¬ 
sonal  trustworthiness  of  a  witness;  for  example,  if  a  child's  back 
is  wounded  in  a  certain  way,  the  shape  of  the  wound  may  be  such 
as  indicates  infallibly  that  it  was  beaten  with  an  instrument  and 
that  the  father's  assertion  about  the  child's  falling  down  stairs  must 
be  false.  The  case  worker  will  have  to  use  both  kinds  of  testi¬ 
monial  evidence — direct  and  indirect.  In  using  indirect  evidence, 
moreover,  he  will  have  to  adapt  his  tests  to  an  infinitely  varied 
subject  matter. 

Besides  these  cardinal  distinctions  of  evidence,  there  are  certain 
minor  distinctions  which  may  be  of  service  to  the  social  worker. 

60 


DEFINITIONS  BEARING  UPON  EVIDENCE 


Oral  testimony  defines  itself.  It  is  the  main  reliance  of  the  social 
diagnostician. 

Documentary  evidence  is  of  many  kinds,  from  formal  documents  of 
legafferigin  to  TEFriiiormal  letters  and  writings  of  private  per¬ 
sons.  This  subject  of  the  uses  of  documents  in  case  work  is  im¬ 
portant  enough  to  receive  separate  treatment  in  Chapter  XIII, 
Documentary  Sources.  ^Suffice  it  to  say  here  that  it  is  a  dangerous 
thing  to  trust  to  anyone’s  memory  of  a  document;  hence  the  rule 
of  law,  Always  look  at  the  document  itself 4  If  a  tenant  says, 
“The  landlord  sent  me  a  notice  to  get  out,”  call  for  the  document. 
It  may  read:  “If  you  do  not  pay  your  rent  by  next  Monday,  I 
will  put  you  out,”  which  is  a  different  thing. 

$ xf>ert  evidence  is  one  species  of  testimonial  evidence.  Its  use 
signifies  that  the  subject  under  consideration  is  one  which  is 
believed  to  need  special  skill  in  observing  and  judging.  The  ad¬ 
vantage  of  expert  testimony  lies  in  the  skill  of  the  person  giving  it. 
A  physiciap  can  tell  to  what  extent  certain  children  are  suffering 
in  health,  whereas  the  social  worker’s  opinion  would  be  of  little 
value.  Hence,  call  in  an  expert  whenever  the  judgment  to  be  made 
is  one  that  should  not  be  based  on  ordinary  experience.  The  dis¬ 
advantage  of  expert  testimony  lies  in  the  bias  which  specialists  are 
apt  to  develop";  A  policeman  is  a  specialist  in  crime;  looking  for 
the  same  thing  always,  his  bias  may  become  in  time  a  marked  ten¬ 
dency  to  expect  to  find  it  on  every  hand. 

Character  evidence  needs  no  defining.  Since  the  social  worker 
seek??€rthscaver  the  possibilities  of  bettering  a  client’s  situation, 
he  naturally  must  look  for  those  traits  in  the  client  and  his  family 
which  may  further  or  obstruct  his  purpose. 

Years  ago,  when  it  often  happened  that  the  choice  of  treat¬ 
ment  hardly  went  further  than  between  the  giving  or  refusing  of 
coal  and  groceries,  character  evidence  in  social  work  was,  as  in  the 
law  courts,  a  mere  generalized  estimate,  favorable  or  unfavorable, 
of  an  individual’s  characteristics.  He  was  either  worthy  of  relief 
or  unworthy.  The  social  worker’s  preoccupation,  like  the  lawyer’s, 
was  with  desert.  Since  on  that  basis  the  case  worker’s  decision 
against  any  client’s  application  for  aid  became  invidious,  the  pre¬ 
sumption,  as  a  matter  of  justice,  had  to  be  in  the  client’s  favor. 
The  burden  of  proof  rested  with  those  who  gave  evidence  as  to 

61 


SOCIAL  DIAGNOSIS 


unworthiness.  One  still  sometimes  finds  this  point  of  view  in 
private  agencies  and  public  departments.  As  a  rule,  however,  the 
case  worker’s  interest  is  approaching  an  impartial  study  of  per¬ 
sonality,  such  as  concerns  itself  not  with  the  meting  out  of  punish¬ 
ment  or  reward  (the  offering  of  almshouse  or  outdoor  relief,  for 
example)  but  with  the  determining  of  all  traits,  whether  in  their 
good  or  their  bad  aspects,  as  they  affect  the  possibility  and  the 
method  of  social  reconstruction.  The  successful  outcome  of  case 
work  is  nowhere  more  dependent  upon  flexibility  of  method  than 
in  the  study  of  personal  traits.  The  choice  of  method  being  wide, 
and  there  being,  generally  speaking,  no  presumption  in  favor  of 
one  diagnosis  rather  than  another,  the  social  case  worker,  like  the 
physician,  has  little  call  to  consider  the  “  burden  of  proof.”  Never¬ 
theless, since  the  worker  in  his  effort  to  arrive  at  an  understanding 
of  a  client’s  personality  must  be  free  to  take  into  account  not  only 
hearsay  evidence  but,  with  due  precautions,  even  rumor,  he  may 
find  it  sometimes  necessary  to  guard  against  his  own  infirmities 
of  judgment  by  placing,  as  already  suggested,  the  burden  of  proof 
with  regard  to  his  client’s  less  admirable  traits  upon  those  who  give 
this  unfavorable  testimonyj 

The  relative  importance  of  the  distinctions  made  in  this  chapter 
is  in  many  ways  greater  to  the  lawyer,  historian,  or  scientist,  than 
to  the  social  wofker.  fJThe  conspicuous  thing  which  the  social  case 
worker  can  learn  from  the  lawyer  is  the  risks  involved  in  the  various 
types  of  evidence,  while  from  the  historian  he  can  learn  the  im¬ 
portance  of  a  rigorous  examination  of  sources  of  information  as  to 
their  trustworthiness,  j  From  physician  and  psychologist  social 
work  has  more  to  learn  than  from  either  lawyer  or  historian,  inas¬ 
much  as  science,  unlike  law  or  history,  can  throw  direct  light  on 
the  social  needs  and  possibilities  of  the  case  worker’s  clients. 

SUMMARY  OF  THIS  CHAPTER 

* 

i.  Social  diagnosis  is  the  attempt  to  arrive  at  as  exact  a  definition  as  possible  of 
the  social  situation  and  personality  of  a  given  client.  The  gathering  of  evidence, 
or  investigation,  begins  the  process,  the  critical  examination  and  comparison  of 
evidence  follows,  and  last  come  its  interpretation  and  the  definition  of  the  social 
difficulty.  Where  one  word  must  describe  the  whole  process,  diagnosis  is  a  better 
word  than  investigation,  though  in  strict  use  the  former  belongs  to  the  end  of  the 
process. 


62 


DEFINITIONS  BEARING  UPON  EVIDENCE 


2.  A  controlling  condition  in  social  diagnosis  is  its  relatively  inelastic  time  limit 
— as  compared,  that  is,  with  other  forms  of  social  inquiry.  This  does  not  mean  that 
a  social  diagnosis  cannot  be  revised;  often  it  must  be.  Another  controlling  condi¬ 
tion  is  the  beneficent  action  always  in  view. 

3.  The  word  fact  is  not  limited  to  the  tangible.  Thoughts  and  events  are  facts. 
The  question  whether  a  thing  be  fact  or  not  is  the  question  whether  or  not  it  can 
be  affirmed  with  certainty.  The  gathering  of  facts  is  made  difficult  by  faulty 
observation,  faulty  recollection,  and  by  a  confusion  between  the  facts  themselves 
and  the  inferences  drawn  from  them. 

4.  Real  evidence  is  the  very  fact  at  issue  presented  to  our  senses.  Testimonial 
evidence  is  the  assertions  of  human  beings.  Circumstantial  evidence  is  the  catch¬ 
all;  it  includes  everything  which  is  not  the  direct  assertion  of  a  human  being — the 
assertion,  that  is,  which  if  true  would  establish  the  point  at  issue. 

5.  The  three  classes  of  evidence  which  are  of  general  application  may  be  distin¬ 
guished  by  the  way  in  which  we  make  inferences  from  them.  In  real  evidence  no 
inference  is  needed;  in  testimonial  evidence  the  basis  of  our  inference  is  a  human 
assertion;  in  circumstantial  evidence  the  basis  of  our  inference  may  be  anything 
at  all. 

6.  There  is  an  important  distinction  in  testimonial  evidence  between  the  evidence 
of  one  who  says  he  saw  or  heard  the  supposed  fact  himself,  and  that  of  one  who 
asserts  it  only  from  what  others  have  told  him.  The  latter  is  hearsay  evidence.  It 
should  be  relied  on  with  caution,  and  a  very  necessary  practice  in  interviewing 
witnesses  is  to  discover  the  extent  to  which  their  assertions  are  founded  on  observa¬ 
tions  or  on  mere  rumor. 

7.  There  is  another  important  distinction  in  evidence  between  direct  and  in¬ 
direct  evidence.  Circumstantial  evidence  is  always  inctirect^nd  characteristically 
cumulative.  In  direct  evidence,  the  only  tests  of  trust^|M:hiness  needed  are  those 
usually  applied  to  human  traits,  such  as  honesty,  bias,  attention,  memory,  sugges¬ 
tibility,  etc. 


•  63 

19,  j? 


CHAPTER  IV 


TESTIMONIAL  EVIDENCE 

AFTER  an  historian  has  established  the  genuineness  and 

ZA  authorship  of  a  document,  his  next  care  is  to  discover  the 
Z  jL  competence  and  bias  of  the  man  who  made  it;  to  go  back, 
in  short,  to  the  testimonial  evidence,  the  human  assertions,  on 
which  the  document  is  based.  The  following  passage  summarizes 
many  of  the  queries  suggested  by  Langlois  and  Seignobos1  in  their 
discussion  of  the  tests  of  an  author’s  good  faith  and  accuracy. 
Questions  of  legal  competency  aside,  it  will  be  seen  that,  with  slight 
variations,  these  tests  would  apply  to  the  competence  and  bias  of 
any  witness.  They  are  most  suggestive  in  the  field  of  social  work 
and  deserve  the  case  worker’s  careful  consideration. 

Good  Faith.  Were  there  any  practical  advantages  to  be  gained  by  the  witness 
who  made  the  statement  in  its  present  form?  Had  he  an  interest  in  deceiving? 
What  interest  did  he  think  he  had?  (We  must  look  for  the  answer  in  his  tastes 
and  ideals,  not  in  our  own.)  If  there  was  no  individual  interest  to  serve,  was 
there  a  collective  interest,  such  as  that  of  a  family,  a  religious  denomination,  a 
political  party,  etc.?  Was  he  so  placed  that  he  was  compelled  to  tell  an  untruth? 
Was  some  rule  or  custom,  some  sympathy  or  antipathy,  dominating  him?  Was 
personal  or  collective  vanity  involved?  Did  his  ideas  of  etiquette,  of  what  polite¬ 
ness  demanded,  run  counter  to  making  a  perfectly  truthful  statement?  [We  do  not 
know  a  man  at  all  until  we  understand  the  conventions  that  form  so  large  a  part  of 
the  moral  atmosphere  which  he  breathes.]  Or  again,  has  he  been  betrayed  into 
telling  a  good  story,  because  it  made  an  appeal  to  the  artistic  sense  latent  some¬ 
where  in  all  of  us? 

Accuracy.  Was  the  statement  an  answer  to  a  question  or  a  series  of  questions? 
(It  is  necessary  to  apply  a  special  criticism  to  every  statement  obtained  by  in¬ 
terrogation.)  What  was  the  question  put,  and  what  are  the  preoccupations  to 
which  it  may  have  given  rise  in  the  mind  of  the  person  interrogated?  Was  the 
observer  well  situated  for  observing?  Was  he  possessed  of  the  special  experience 
or  general  intelligence  necessary  for  understanding  the  facts?  How  long  before 
he  recorded  what  he  observed?  Or  did  he  record  it,  like  some  newspaper  accounts 
of  meetings,  before  it  happened?  Finally,  was  the  fact  stated  of  such  a  nature  that 
it  could  not  have  been  learned  by  observation  alone? 

1  Introduction  to  the  Study  of  History,  p.  165-176. 

64 


TESTIMONIAL  EVIDENCE 


Like  the  historian,  the  case  worker  must  have  for  the  weighing 
of  the  evidence  with  which  he  deals  a  clear  understanding  of  the 
two  factors  which  condition  the  value  of  testimony;  namely,  (i) 
the  witness’s  opportunity  to  know  the  facts  and  the  way  in  which 
he  has  used  this  opportunity — his  competence,  in  short;  and  (2) 
those  ideas  or  emotions  of  the  witness  which  may  prejudice  his 
judgment — his  bias. 

I.  THE  COMPETENCE  OF  THE  WITNESS 

Case  workers  heed  the  competence  of  a  witness  only  in  an 
unavowed  and  hit-or-miss  fashion.  Their  daily  experience  it  is 
true  teaches  them  to  take  roughly  into  account  the  witness’s  op¬ 
portunity  to  know  the  facts.  For  instance,  they  frequently  find 
that  the  person  referring  a  client  for  care  thinks  he  has  had  ample 
opportunity  to  know  the  client’s  affairs  when  the  reverse  is  the  case. 

A  charitable  woman  asked  relief  for  a  capable  widow  whom  she  said  she  had 
known  well  for  years.  It  appeared,  however,  that  she  did  not  know  how  many 
children  were  at  home,  whether  the  oldest  son  was  working,  what  were  the  woman’s 
habits  as  to  drink,  what  the  family  income  was,  or  whether,  in  fact,  they  needed  aid 
at  all.  She  had  not  been  to  the  home  of  this  family  for  several  years,  and  had 
taken  the  statement  of  need  as  the  widow  gave  it  .to  her  one  day  in  church.  The 
charitable  woman  was  quite  surprised,  as  her  conversation  with  the  secretary  of  the 
agency  proceeded,  to  discover  how  superficial  was  her  knowledge  of  any  of  the  real 
circumstances  of  the  widow’s  family  life. 

The  social  worker  has  to  be  on  guard  against  this  same  risk  in 
consulting  the  relatives  of  a  client.  Some  relatives  know  a  great 
deal,  and  others,  who  think  they  know  everything,  really  know  very 
little. 

An  agency  tried  to  interest  fairly  well-to-do  relatives  in  the  needs  of  a  delicate 
man  with  a  wife  and  several  children.  They  were  not  responsive.  They  claimed 
they  had  already  helped  more  or  less,  that  they  had  burdens  of  their  own,  and  that 
he  was  a  loafer,  a  “poor  shrimp,”  as  one  of  the  kin  described  him.  It  turned  out 
that  the  man  had  locomotor  ataxia,  the  result  of  syphilis.  With  this  medical  diag¬ 
nosis,  which  explained  to  a  considerable  extent  the  man’s  ill  success,  the  worker 
again  appealed  to  the  relatives,  this  time  with  good  results. 

This  man’s  brothers  and  cousins  had  had  no  opportunity  to  learn 
the  crucial  point  in  his  situation,  and  were  therefore  not  competent 
witnesses  as  to  his  character  for  industry. 

Ordinarily  employers  would  not  be  competent  witnesses  as  to  a 

65 


SOCIAL  DIAGNOSIS 


man’s  home  conditions;  social  acquaintances  as  to  his  industrial 
capacity;  nor  a  social  agency  that  trusted  to  intuitions  as  to  his 
personal  repute.  These  would  be  facts  concerning  which  the 
groups  named  could  have  had  no  knowledge. 

The  use  which  a  witness  has  made  of  his  opportunity  to  know  the 
facts  is  a  subject  which  social  workers  have  hardly  begun  to  con¬ 
sider;  it  therefore  does  not  admit  of  adequate  discussion  at  present. 
Inasmuch  as  this  use  depends  upon  the  witness’s  powers  of  atten¬ 
tion  and  memory,  upon  his  suggestibility,  etc.,  any  searching  in¬ 
quiry  into  the  relation  of  these  factors  to  a  witness’s  competence 
must  come  from  the  psychologists.  To  case  workers,  however,  will 
have  to  be  entrusted  the  application  of  the  elements  of  psychology 
to  testimonial  evidence  in  their  own  field. 

1.  Attention.  The  closeness  of  attention  on  the  part  of  any  wit¬ 
ness  to  an  incident  in  his  own  or  another’s  situation1  depends  upon 
the  importance  which  at  the  time  he  attaches  to  it,  or,  it  may  be, 
upon  the  existence  of  a  similarity  between  some  part  of  that  inci¬ 
dent  and  something  which  he  has  experienced  before — upon  his 
“funded  thought.”2  This  “funded  thought”  is  his  material  for 

1  In  one  of  the  short,  unpublished  papers  referred  to  in  the  Preface,  Mr.  Julian 
Codman,  writing  on  “  Evidence  in  its  Relation  to  Social  Service,”  gives  the  follow¬ 
ing  instance  of  inattention: 

One  day  Mr.  P,  a  lifelong  resident  of  Nahant,  a  man  of  high  cultivation  and 
exceptional  ability,  and  an  enthusiastic  golfer,  came  to  the  chairman  of  the  green 
committee  of  the  Golf  Club  and  told  him  that  he  thought  part  of  the  course  was 
unsafe  for  passers-by.  This  was  a  place  where  the  county  road  crossed  the  course. 
He  said  that  he  thought  a  notice  should  be  put  up  warning  all  players  to  look  and 
see  that  the  road  was  clear  of  foot-passengers  and  carriages  before  playing  a  ball 
from  the  teeing  ground.  The  chairman  suggested  a  notice  as  follows,  and  asked 
if  that  would  be  sufficient: 

“  DANGER:  All  persons  before  driving  from  this  tee  are  cautioned  to  see  that 
no  one  is  passing  in  the  road.” 

Mr.  P  said  that  he  thought  such  a  sign  would  be  just  the  thing. 

“Well,”  said  the  chairman,  “a  sign  in  exactly  those  words  in  letters  three  inches 
long  in  black  paint  on  a  white  ground  has  been  in  front  of  your  eyes  every  time  you 
have  driven  off  that  tee  during  the  last  six  years.” 

Have  you  any  doubt  that,  if  Mr.  P  had  been  called  on  the  witness-stand  to 
testify  as  to  the  presence  or  absence  of  a  sign  in  that  particular  tee,  he  would  have 
taken  his  oath  that  no  such  sign  existed?  And  he  would  have  so  sworn  with  the 
utmost  confidence  in  his  correctness.  [The  explanation  for  this  gentleman’s  ap¬ 
parent  inattention  may  have  been  that  for  six  years  he  had  heeded  the  warning 
given  by  the  sign  board  automatically,  and  that  therefore  its  importance  for  him¬ 
self  had  long  disappeared.] 

2  “  I  remember  vividly  a  case  of  jealous  murder  in  which  the  most  important 
witness  was  the  victim’s  brother,  an  honest,  simple  woodsman,  brought  up  in  the 
wilderness,  and  in  every  sense  far-removed  from  idiocy.  His  testimony  was  brief, 

66 


TESTIMONIAL  EVIDENCE 

thinking,  the  sum  total  of  ideas  which  his  traditions,  education,  and 
experience  have  made  an  integral  part  of  his  mind.  New  experience 
which  is  entirely  strange,  which  he  can  relate  to  nothing  in  his  past 
thinking,  he  will  not  heed. 

A  woman  whose  husband  showed  signs  of  mental  disturbance  consented  to  his 
being  observed  with  a  view  to  commitment  for  hospital  care.  She  did  this,  how¬ 
ever,  merely  because  she  was  desperate  at  what  she  considered  his  incorrigible 
laziness,  and  because  she  knew  she  would  be  better  off  without  him.  The  social 
worker  interested  could  neither  make  her  see  that  he  was  other  than  normal  men¬ 
tally,  nor  give  her  a  conception  of  what  it  meant  to  be  insane  without  violent  mania. 
His  occasional  abuse  of  his  wife,  his  desire  to  keep  her  in  the  house  so  that  she 
should  not  talk  with  neighbors,  his  ungrounded  suspicions  of  her  fidelity  and  of  his 
son’s  honesty,  she  apparently  took  for  granted  as  “crankiness — the  way  he  was 
made.”  His  incompetence  even  in  the  least  skilled  work  she  of  course  accounted 
for  as  wilful  indolence. 

This  woman  was  familiar  with  the  idea  of  the  unreasonable  and 
lazy  husband,  and  totally  unfamiliar  with  the  idea  of  an  early 
stage  of  insanity.  This  last  idea  therefore  could  not  command  her 
attention  and  credence  as  an  explanation  of  her  troubles.  A  case 
worker  who  wants  to  get  evidence  throwing  light  on  mental  abnor¬ 
malities  from  uneducated  people  is  likely  to  have  better  success  by 
leading  them  to  talk  not  about  “peculiarities”  but  about  temper, 
laziness,  etc. — familiar  domestic  phenomena.  The  social  worker, 
then,  in  weighing  evidence,  must  take  account  of  differences  in  the 
funded  thought  of  witnesses,  in  so  far  as  this  is  likely  to  affect 
the  objects  or  incidents  to  which  a  particular  witness  will  give 
attention. 

The  influence  of  the  social  worker’s  own  funded  thought  upon 
his  success  in  collecting  evidence  shows  in  the  following  instance, 
supplied  by  one  who  was  training  young  case  workers: 

decided,  and  intelligent.  When  the  motive  for  the  murder,  in  this  case  most 
important,  came  under  discussion,  he  shrugged  his  shoulders  and  answered  my 
question — whether  it  was  not  committed  on  account  of  a  girl — with  ‘Yes,  so  they 
say.’  On  further  examination  I  reached  the  astonishing  discovery  that  not  only 
the  word  ‘jealousy’  but  the  very  notion  and  comprehension  of  it  were  totally  foreign 
to  the  man.  The  single  girl  he  at  one  time  had  thought  of  had  been  won  away 
from  him  without  making  him  quarrelsome,  nobody  had  ever  told  him  of  the  pangs 
and  passions  of  other  people,  he  had  had  no  occasions  to  consider  the  theoretic 
possibility  of  such  a  thing,  and  so  ‘jealousy’  remained  utterly  foreign  to  him.  It 
is  clear  that  his  hearing  now  took  quite  another  turn.  All  I  thought  I  heard  from 
him  was  essentially  wrong;  his  ‘funded  thought’  concerning  a  very  important,  in 
this  case  a  regulative,  concept,  had  been  too  poor.” — Gross,  Criminal  Psychology, 
p.  21-22. 


67 


SOCIAL  DIAGNOSIS 


A  post-graduate  student  in  sociology  had  been  sent,  after  careful  directions,  to 
visit  a  family,  but  apparently  there  had  been  no  hooks  in  his  mind  on  which  to 
hang  his  instructions.  He  could  not  tell,  when  he  returned  to  the  office,  whether 
the  wife  and  mother  seemed  in  good  health  or  bad,  he  had  no  idea  of  the  woman’s 
approximate  age,  or  of  the  number  of  her  children  (there  were  a  lot,  he  thought), 
of  the  number  and  size  of  the  rooms,  or  of  their  condition.  But  he  did  learn  that 
the  husband  and  father  was  working  and  that  he  was  a  member  of  a  union.  As 
the  young  man  was  writing  a  thesis  upon  Trade  Unionism,  the  inference  is  obvious. 
He  saw  vwhat  he  knew  enough  to  notice. 

2.  Memory.  Social  case  records  are  “a  series  of  miniature  biog¬ 
raphies/’  says  Professor  J.  M.  Vincent,  “the  materials  for  which  are 
gathered  while  the  subject  is  still  living.  In  part  these  are  auto¬ 
biographical  and  have  both  the  strength  and  weaknesses  of  per¬ 
sonal  memoirs.”1  The  weakness  of  personal  memoirs  is  the  mis¬ 
leading  impression  that  they  give  of  being  contemporary  testimony 
when  they  are  not;  in  reality  they  are  memory  material;2  the  most 
significant  things  that  they  narrate  may  have  happened  months 
or  years  before. 

It  is  characteristic  of  the  uneducated  narrator  with  whom  the 
social  worker  frequently  has  to  deal  that  he  must  often  arrive  in¬ 
directly  at  the  time  which  has  elapsed  since  any  given  event.  He 
remembers  by  associating  this  event  with  certain  others,  the  dates 
of  which  are  wellknown,  such  as  a  public  calamity  (a  war,  earth¬ 
quake,  or  fire) ;  a  national  or  civic  landmark  (a  holiday,  an  election) ; 
a  family  event  which  is  on  record  (a  birth,  marriage,  or-death);  a 
natural  phenomenon  (the  seasons,  the  tides,  the  weather).3 

What  appears  a  defect  in  memory  may  sometimes  be  the  inex¬ 
pressiveness  often  met  in  ignorant  people,  an  inability  to  find  or 
to  arrange  in  cogent  order  the  words  needed  to  describe  a  past 
experience.4  The  silence  of  the  peasant  has  probably  a  different 

1  From  one  of  the  short,  unpublished  papers  referred  to  in  the  Preface. 

2  See  Langlois  and  Seignobos,  An  Introduction  to  the  Study  of  History,  p.  175. 

3  The  distance  in  time  between  two  events  both  of  which  are  in  question  is  ar¬ 
rived  at  in  the  same  way.  “  If  anybody  says  that  event  A  occurred  four  or  five  days 
before  event  B,  we  may  believe  him,  if,  e.  g.,  he  adds,  ‘  For  when  A  occurred 
we  began  to  cut  corn,  and  when  B  occurred  we  harvested  it.  And  between  these 
two  events  there  were  four  or  five  days.’  ” — Gross,  Criminal  Psychology,  p.  384. 

4  “In  other  words,  discrepancies  or  inadequacies  may  appear  in  reports,  which 
are  due,  not  only  to  misdirected  attention,  malobservation,  and  errors  of  memory, 
but  also  to  lack  of  caution  or  of  zeal  for  accurate  statement,  to  scanty  vocabulary, 
to  injudicious  phraseology,  or,  of  course,  to  deliberate  intent  to  mislead.’’ — Guy 
M.  Whipple,  reprinted  by  Wigmore  in  Principles  of  Judicial  Proof,  p.  576. 

68 


TESTIMONIAL  EVIDENCE 


source.  One  worker  of  considerable  experience  with  Lithuanian 
peasants  attributes  it  to  their  doubt  as  to  what  is  going  on  in 
the  stranger’s  mind,  and  whether  the  latter  thinks  in  the  same 
way  as  do  their  own  people.  As  they  find  common  intellectual 
ground,  they  drop  their  reticence.  It  takes  no  small  skill  on  the 
part  of  an  interviewer,  however,  to  start  the  train  of  ideas  which 
will  induce  frank  communication  from  such  people. 

Memory  material  is  liable  to  two  changes  in  repeated  reporting. 

Whipple  calls  attention  to  the  fact  that  repetition  “tends  in  part  to  establish  in 
mind  the  items  reported,  whether  they  be  true  or  false,  and  .  .  .  tends  also  to 
induce  some  departure  in  the  later  reports,  because  these  are  based  more  upon  the 
memory  of  the  verbal  statements  of  the  earlier  reports  than  upon  the  original 
experience  itself.”1 

In  social  case  work  the  first,  unrehearsed  statement  of  a  client  or 
of  those  who  know  him  is  likely  to  be  the  fullest  and  most  reliable. 
Competent  workers  dread  the  client  who  has  told  his  story  to  sev¬ 
eral  different  social  agencies.  Becoming  tired  of  repeating  his  ac¬ 
count  of  his  situation,  he  leaves  out  essential  parts,  or  else,  having 
found  that  certain  incidents  had  a  desired  influence  upon  his 
hearers,  he  emphasizes  them  and  perhaps  slights  others  quite  as 
significant. 

3.  Suggestibility.  A  third  factor  which  affects  a  person’s  com¬ 
petence  as  a  witness  is  his  suggestibility.  By  that  we  mean  an 
over-readiness  to  yield  assent  to  and  to  reproduce  the  assertions 
of  other  people.  A  witness  may  confuse  observations  made  by 
others  with  his  own;  he  may  give  a  facile  acceptance  to  what  he 
reads2  as  well  as  to  what  he  hears.  Dr.  Frankwood  E.  Williams,3 
when  secretary  of  the  Massachusetts  Society  for  Mental  Hygiene 
and  member  of  the  Prison  Board  in  that  state,  noted  as  one  of  the 
most  conspicuous  factors  in  the  misdoings  of  boys  at  the  State 

1  Whipple,  reprinted  by  Wigmore  in  Principles  of  Judicial  Proof,  p.  580. 

2  “A  first  and  natural  impulse  leads  us  to  accept  as  true  every  statement  con¬ 
tained  in  a  document,  which  is  equivalent  to  assuming  that  no  author  ever  lied  or 
was  deceived;  and  this  spontaneous  credulity  seems  to  possess  a  high  degree  of 
vitality,  for  it  persists  in  spite  of  the  innumerable  instances  of  error  and  mendacity 
which  daily  experience  brings  before  us.” — Langlois  and  Seignobos,  Introduction 
to  the  Study  of  History,  p.  155. 

3  Now  Associate  Medical  Director  of  the  National  Committee  for  Mental  Hy¬ 
giene. 

69 


SOCIAL  DIAGNOSIS 


i 


Industrial  School  at  Shirley  their  ready  suggestibility  for  either 
good  or  evil.1 

A  children’s  agency  had  a  discouraging  struggle  with  an  unusually  bright  girl 
in  her  early  teens.  She  came  under  the  influence  of  two  older  girls  of  low  character 
and  did  just  what  they  proposed,  which  was  to  go  on  the  street.  On  the  other 
hand,  when  under  the  influence  of  the  agency’s  visitor,  she  conducted  herself 
properly  and  showed  an  ambition  to  make  something  of  herself.  In  company  with 
respectable,  intelligent  people,  she  rose  to  their  level,  but  would  drop  back  again 
the  moment  she  chanced  upon  evil  counsels.  She  would  be  as  absorbed  in  a  re¬ 
vival  meeting  as  in  some  sailor  whom  she  happened  upon  afterwards.  This  girl, 
although  aware  of  her  suggestibility  and  of  just  how  it  might  affect  her  prospects, 
apparently  could  not  control  it. 

The  following  illustration,  although  of  an  adult,  shows  the  same 
weakness: 

A  man  who  was  a  good  workman,  married,  with  several  children,  lost  two  suc¬ 
cessive  positions  on  the  ground  of  his  dishonesty.  The  second  time  the  charge 
was  that  of  receiving  stolen  goods,  the  theft  itself  having  been  committed  by  two 
other  employes.  Between  his  arrest  and  trial  he  got  work  as  a  chauffeur,  and  used 
his  employer’s  car  without  permission  until  he  ran  into  a  telegraph  pole  and  dam¬ 
aged  the  machine.  He  was  placed  on  probation  for  a  year.  After  a  few  months 
of  temporary  jobs,  his  probation  officer  got  him  steady  work.  From  then  on  he 
improved,  receiving  an  advance  in  wage  and  then  the  promise  of  a  foremanship. 
To  the  delight  of  his  wife,  his  interest  in  his  children  awakened.  The  man  himself 
said  he  owed  all  to  the  probation  officer,  who,  as  he  observed,  was  wonderful  in  his 
understanding  of  men.  Unfortunately  for  this  fellow,  probation  terms  end.  At 
last  accounts  he  had  disappeared,  leaving  his  children  to  be  supported  by  charity. 
While  under  the  supervision  of  a  man  of  good  standards  this  man  could  keep 
straight.  Without  that  brace  he  went  to  pieces. 

The  case  worker  must  bear  in  mind  that  suggestibility  may  in¬ 
fluence  not  only  the  client’s  conduct,  but  also  his  thinking  and  his 
standards.  The  girl  just  cited,  in  the  presence  of  a  refined,  earnest 
woman  worker,  would  rise  above  the  coarse  speech  and  free 
demeanor  which  she  finds  an  asset  among  low  companions.  A 
kindly  bias  common  to  social  workers  leads -them,  in  the  case  of 
any  client  who  interests  them,  especially  a  young  one,  to  try  to 
get  at  those  traits  that  give  most  promise  of  amended  conduct. 
Roused  by  this  bias,  the  girl’s  suggestibility,  taken  together  with 

1  “The  one  factor  that  more  than  any  other  is  responsible  for  the  poor  reports 
of  children  is  their  excessive  suggestibility,  especially  in  the  years  before  puberty.” 
(Whipple,  reprinted  by  Wigmore  in  Principles  of  judicial  Proof,  p.  580.)  This 
is  strikingly  illustrated  in  Whipple’s  report  of  a  Belgian  murder  trial,  reprinted  by 
Wigmore.  (The  Puyenbroeck  Case,  Principles  of  Judicial  Proof,  p.  521.) 

70 


TESTIMONIAL  EVIDENCE 


her  desire  to  please,  may  make  her  not  only  seem  but  be  so  different 
a  person  while  in  the  presence  of  the  social  worker  that  the  latter 
forms  a  mistaken  estimate  of  her  character  as  a  whole.  What  is 
true  of  such  a  girl  as  the  one  referred  to,  is  true  to  a  lesser  extent 
of  the  man  who  was  influenced  by  the  probation  officer. 

Suggestibility  may  even  reach  the  extent  of  leading  to  mistaken 
confessions: 

A  judge  was  about  to  sentence  to  prison  a  woman  who  had  been  arrested  for 
disorderly  conduct  and  for  attracting  a  crowd  on  the  street.  Although  she  made  a 
long  and  circumstantial  confession  of  immorality,  her  apathetic  manner  awakened 
doubt  in  the  mind  of  a  social  worker  present.  This  worker,  having  secured  a  sus¬ 
pension  of  sentence,  traced  the  woman’s  husband  and  relatives  to  another  city  and 
found  that  her  claim  to  have  been  long  leading  a  prostitute’s  life  was  without 
foundation.  The  prisoner’s  “disorderly  conduct’’  was  due  to  an  epileptic  seizure. 
Her  confession  showed  the  need,  not  of  a  prison  sentence,  but  of  observation  in  a 
psychopathic  hospital. 

This  woman,  arrested  for  disorderly  conduct,  was  undoubtedly 
assumed  by  the  police  to  be  of  low  character  and  probably  put  in 
jail  among  women  of  this  sort.  May  the  layman  venture  to  sur¬ 
mise  that  the  frank  talk  about  unsavory  experiences  to  which  such 
women  are  prone,  and  to  which  she  would  have  been  a  listener,  may 
have  suggested  to  her  enfeebled  mind  the  story  she  told  the  court? 

4.  Leading  Questions.  Closely  related  to  the  suggestibility  of 
witnesses  is  the  response  which  they  may  make  to  “  leading  ques¬ 
tions/'  The  social  case  worker  must  be  on  guard  against  getting 
back  as  alleged  fact  some  mere  conjecture  of  his  own  which  he  has 
implicitly  expressed  by  his  wording,  or  by  the  inflection  of  his  voice. 
A  case  worker  with  little  faith  may  ask,  “You  have  no  relatives 
who  would  take  in  the  baby  while  you  go  to  the  hospital,  have 
you?";  whereas  the  worker  who  gets  results  would  put  the  ques¬ 
tion,  “Which  of  your  sisters  could  best  take  the  baby?" 

A  worker  in  training  reported  to  the  district  secretary  under  whom  she  was 
visiting  that  one  of  her  clients  had  misrepresented  her  daughter’s  wages.  The 
secretary  asked,  “  Did  Mrs.  B  actually  say  that  Bertha  was  earning  $5.00  a  week?” 
After  thinking  a  moment,  the  worker  replied,  “Why  no,  but  when  I  said,  ‘Bertha 
is  earning  $5.00  a  week,  is  she  not?’  she  said  ‘Yes.’” 

The  permissibility  of  leading  questions1  in  social  work  is  solely 

1  In  courts  of  law  those  leading  questions  are  objectionable  in  direct  examina¬ 
tions  (1)  which  embody  a  material  fact  and  suggest  a  desired  “yes”  or  “no”  in 

71 


SOCIAL  DIAGNOSIS 


a  matter  of  adapting  the  means  in  a  given  case  to  the  end  in  view. 
This  end,  the  social  readjustment  of  the  client  and  of  his  affairs, 
may  be  defeated  by  a  detective  manner  or  by  a  shrewd  framing  of 
questions  such  as  places  the  subject  at  a  disadvantage.  The  stage 
of  social  inquiry  in  which  case  investigators  prided  themselves  upon 
an  ability  to  catch  people  tripping,  to  surprise  an  admission,  has 
given  way  to  a  diagnostic  method  which,  shunning  small  subter¬ 
fuges  such  as  raise  barriers  between  worker  and  client,  establishes 
the  latter’s  confidence  by  a  direct  approach  and  by  putting  aside, 
to  be  sought  elsewhere,  questions  that  can  be  answered  equally  well 
from  another  source. 

“In  my  early  experience,”  writes  Miss  Zilpha  D.  Smith,  “I  was  apt,  in  inter¬ 
views,  to  make,  out  loud,  deductions  from  what  had  been  told  me,  and  then  ask  if 
my  conclusion  was  right.  I  learned  to  check  myself  in  doing  this,  for  it  invited  un¬ 
true  statements.” 

It  is,  however,  not  always  possible  to  avoid  leading  questions. 
Some  minds  are  so  sluggish,  others  so  unwilling  or  unable  to  recol¬ 
lect  a  series  of  events  until  a  starting  point  has  been  supplied,  that 
the  common  rule  against  leading  questions  in  case  work,  like  the 
similar  rule  in  law,  must  be  “understood  in  a  reasonable  sense.”1 
Some  forms  of  the  leading  question  remove  the  temptation  to 
be  untruthful,  as  in  the  following  example: 

A  medical-social  worker  was  talking  with  a  patient  about  whom  there  was  a  per¬ 
ceptible  odor  of  strong  drink.  She  began,  "What  kind  of  liquor  do  you  ordinarily 
drink  and  how  much?”  Then,  not  waiting  for  an  answer,  continued,  “With  the 
disease  which  you  have  and  the  kind  of  medicine  you  are  taking,  all  liquor  is  bad, 
and  certain  kinds  are  very  dangerous.”  The  man  told  her  that  he  took  gin  and  how 
much.  She  feels  that  had  she  asked,  “  Do  you  drink?”  he  would  have  denied  it. 

The  question  “  Do  you  drink?”  is  often  taken  to  mean  “  Do  you 
drink  to  excess?”  “Are  you  a  drunkard?”  and  is  of  course  offensive. 
The  worker  framed  her  question  in  a  way  dictated  as  much  by 
politeness  as  by  investigating  skill. 

It  cannot  be  claimed  that  framing  such  questions  as  will  elicit 
the  truth  is  always  easy,  nor  will  there  be  unanimity  of  opinion  as 

reply;  (2)  which  contain  assumptions  that  facts  are  known  that  are  not  known, 
or  that  answers  have  been  given  that  have  not  been  given;  (3)  which  constitute  an 
argumentative  series.  See  Greenleaf  on  Evidence,  p.  538  sq.,  for  exceptions  to 
these  rules. 

1  Greenleaf  on  Evidence,  p.  537. 

72 


( 


TESTIMONIAL  EVIDENCE 


to  what  is  and  what  is  not  permissible  on  ethical  grounds.  Take, 
for  illustration,  a  statement  in  Mrs.  Solenberger’s  book  on  Home¬ 
less  Men.1  To  a  homeless  man  of  over  thirty,  applying  for  relief 
and  guidance,  she  was  accustomed  to  say  in  her  first  interview  not 
“Are  you  married?”  but  “Where  is  your  wife?”;  not  “Have  you 
a  family?”  but  “  How  much  of  a  family  have  you?”  Some  students 
of  social  work  have  objected  to  this  as  a  form  of  deception,  advo¬ 
cating  “Are  you  married?”  as  the  more  honest  question.  Experi¬ 
ence  has  shown,  however,  that  “Are  you  married?”  usually  leads 
to  the  answer  “No,”  while  “Where  is  your  wife?”  usually  reveals 
the  existence  of  a  wife. 

A  doctor  once  gave  an  amusing  example  of  how  to  avoid  the 
leading  question.  He  found  that  when  he  asked  his  patients 
whether  they  were  better  they  said  “Yes,”  and  when  he  asked  them 
whether  they  were  worse,  they  also  said  “Yes,”  so  that  he  had 
learned  to  force  from  them  an  original  opinion  by  framing  his 
inquiry:  “Well,  are  you  worse  or  better,  or  how  are  you  this  morn¬ 
ing?”  Questions  can  often  be  avoided  by  the  use  of  circumstantial 
evidence.  A  probation  officer  need  not  say  “  Do  you  smoke  cigar¬ 
ettes?”  but  “Let  me  look  at  your  hands.” 

To  sum  up,  leading  questions  may  suggest  to  the  client  answers 
which  are  not  true,  or  they  may  prevent  the  establishment  of  con¬ 
fidence  between  worker  and  client.  When  used  at  all,  it  should  be 
with  an  awareness  of  these  dangers  on  the  part  of  the  social  worker. 

II.  THE  BIAS  OF  THE  WITNESS 

1.  Racial  or  National.  The  risk  of  bias  in  testimony  is  so  obvious 
that  social  workers  become  alive  to  it  in  a  general  way.  In  the 
industrial  centers  of  the  United  States  bias  arising  from  race  must 
be  constantly  allowed  for.  One  of  the  social  worker’s  difficulties 
with  foreigners  is  that  he  does  not  understand  their  conventions 
any  more  than  they  do  his;  a  knowledge  of  their  history  and  of 
their  old  world  environment  is  indispensable  to  the  most  helpful 
relations  with  them.  In  a  paper  on  a  group  of  South  Italians2 
known  to  her  as  a  social  worker,  Miss  Ida  Hull  names,  among  other 

1  Solenberger,  Alice  Willard:  One  Thousand  Homeless  Men.  A  Study  of  Origi¬ 
nal  Records,  p.  22.  Russell  Sage  Foundation  Publication.  New  York,  Charities 
Publication  Committee,  1911. 

2  One  of  the  short,  unpublished  papers  referred  to  in  the  Preface. 

,  73 


SOCIAL  DIAGNOSIS 


things  to  be  kept  in  mind,  the  fact  that  they  have  tilled  the  $5il 
of  their  primitive  communities  according  to  Virgilian  methods,  that 
they  have  lived  where  parish  jealousies  were  strong,  where  the 
machinery  of  government — of  the  courts,  for  instance — was  dis¬ 
trusted;  that  they  are  intensely  proud  of  their  race  and  their  lan¬ 
guage,  and  resentful,  therefore,  of  any  assumption  of  superiority 
in  others;  that  they  act  from  emotional  rather  than  from  reasoned 
motives;  and  that  they  prefer  the  leisurely  and  indirect  approach. 

Letting  fly  the  question  direct  means  receiving  in  return  evasions,  prompted  by 
a  repugnance  for  what  seems  intruding  brusqueness.  Hurry  is  absolutely  fatal  to 
a  successful  interview.  Social  amenities  must  have  their  place,  and  the  conversa¬ 
tion  must  proceed  in  such  fashion  that  the  important  point  seems  to  come  in  rather 
incidentally,  or  to  be  suggested  by  the  family  itself. 

The  perplexing  experience  of  a  young  worker  bears  this  out.  She 
was  an  enthusiastic  and  capable  college  graduate  who  belonged  to 
the  Society  of  Friends  and  had  been  trained  to  the  habit  of  telling 
the  unflinching  truth.  Whenever  she  visited  a  family  in  “  little 
Italy”  who  were  bred  in  the  tradition  that  the  courteous  thing  to 
do  was  to  say  whatever  a  guest  seemed  to  desire  said,  there  was  a 
clash  of  standards  which  finally  brought  about  her  assignment  to 
a  district  less  alien  to  her  traditions. 

Social  workers  will  sometimes  meet  a  class  bias  in  peasants  from 
the  old  world.  The  case  worker  is  more  likely  to  assume  humility 
in  a  peasant  than  to  recognize  his  family  pride  and  the  grounds  for 
it.  For  example, 

A  young  peasant  girl  expressed  astonishment  that  an  older  woman,  who  had 
been  adopted  from  an  institution  in  childhood,  had  been  able  to  get  a  good  hus¬ 
band.  She  wondered  that  such  a  man  would  take  a  woman  when  he  could  not 
know  from  what  sort  of  people  she  came.  She  herself  was  expecting  to  marry  a 
man  the  character  of  whose  forbears  she  knew  as  well  as  she  knew  her  own. 

Such  a  girl  would  be  likely  to  give  biased  evidence  about  one 
who  was  without  established  family  respectability.  Miss  Emily 
G.  Balch  describes  the  peasant  attitude  as  follows: 

A  peasant  is  thus  something  quite  distinct  from  anything  that  we  know  in  Amer¬ 
ica.  On  the  one  hand,  he  is  a  link  in  a  chain  of  family  inheritance  and  tradition 
that  may  run  back  for  centuries,  with  a  name,  a  reputation,  and  a  poSTSfity*  On 
the  other  hand,  he  is  confessedly  and  consciously  an  inferior. 


TESTIMONIAL  EVIDENCE 


And  of  racial  bias  among  the  various  Slavic  nationalities,  she 
says, 


In  American  communities  they  have  different  churches,  societies,  newspapers, 
and  a  separate  social  life.  Too  often  the  lines  of  cleavage  are  marked  by  antipathies 
and  old  animosities.  The  Pole  wastes  no  love  on  the  Russian,  nor  the  Ruthenian 
on  the  Pole,  and  a  person  who  acts  in  ignorance  of  these  facts  .  .  .  may  find 

himself  in  the  position  of  a  host  who  should  innocently  invite  a  Fenian  from  County 
Cork  to  hobnob  with  an  Ulster  Orangeman  on  the  ground  that  both  were  Irish.1 

One  in  receipt  of  unfavorable  evidence  from  a  Pole  about  a  Russian, 
therefore,  would  have  to  allow  not  so  much  for  personal  as  for 
racial  bias. 

The  use  of  interpreters  also  presents  difficulties.  When  people 
who  do  not  speak  English  have  to  be  interviewed  through  one,  the 
results  are  the  reverse  of  satisfactory.  As  one  worker  put  it,  if  an 
interpreter  can  fulfill  his  part  in  an  honest,  unbiased,  and  intelligent 
way,  he  had  better  be  turned  into  a  social  worker  and  do  the  case 
work  needed  himself.  Such  interpreters  are  almost  non-existent. 

A  Polish  interpreter,  either  through  a  misunderstanding  or  from  self-interest, 
told  a  deserted  wife  with  three  children  that  she  was  to  be  deported  by  the  state. 
She  ran  off,  leaving  the  children  to  public  care.  It  took  two  months  to  find  her  and 
reunite  her  and  the  children,  and  three  years  for  the  state  visitor  to  gain  her  con¬ 
fidence.  Her  bias  naturally  inclined  her  to  trust  the  statement  of  one  of  her  own 
race  and  language.2 

2.  Environmental.  Bias  also  accompanies  standards  of  conduct 
springing  from  this  or  that  kind  of  education  or  environment. 

An  ex-probation  officer  states  that  the  police  officers  other  than  the  one  making 
the  arrest  in  the  criminal  courts  where  he  served  would  never  give  him  unfavorable 
information  about  a  prisoner  before  sentence.  They  would  allow  him  to  spend 
several  hours  running  down  previous  arrests,  etc.,  or  would  be  silent  while  the 
court  gave  him  some  old  jailbird  as  a  probationer  for  a  first  offense,  rather  than  be 
guilty  of  the  meanness,  as  they  thought  it,  of  hitting  a  man  who  was  down.3  After 
the  case  was  settled  they  would  tell  what  they  knew,  showing  respect  for  the  proba¬ 
tion  officer’s  acuteness  if  he  had  not  been  fooled  and  some  good-natured  contempt 
for  him  if  he  had.  It  never  occurred  to  them  that  to  succeed  in  eluding  justice 
might  have  a  bad  effect  upon  the  prisoner’s  character. 

1  Our  Slavic  Fellow  Citizens,  p.  42  and  p.  8. 

2  See  also  reference  to  interpreters  in  Chapter  VI,  The  First  Interview,  p.  1 18  sq. 

3  The  need  of  better  court  records,  which  would  have  saved  the  probation  officer 
and  his  client  from  some  of  these  mistakes,  is  discussed  in  Chapter  XIII,  Documen¬ 
tary  Sources. 


75 


SOCIAL  DIAGNOSIS 


One  meets  this  personal  as  contrasted  with  a  social  standard  of 
ethics  frequently  in  people  of  fine  character  and  of  otherwise  good 
intelligence.  Mayors,  clergymen,  teachers,  employers  may  sup¬ 
press  the  truth  where  they  think  this  would  help  someone  for  whom 
they  are  sorry.  They  want  to  give  him  “another  chance,”  often 
regardless  of  the  chances  he  may  have  already  wasted,  and  of  the 
treatment  best  calculated  to  make  him  a  useful  citizen. 

A  woman  whose  maid  had  caused  her  great  annoyance  by  staying  out  till  the 
small  hours  night  after  night,  and  had  rater  left  because  pregnant,  told  none  of  this 
to  another  mistress  who  inquired  about  the  girl  some  months  later.  She  said  she 
did  not  want  to  be  the  one  to  do  it. 

This  woman  thought  she  was  being  kind.  Again,  as  in  the  case 
of  the  police,  it  never  occurred  to  her  that  this  might  be  a  poor  way 
to  get  the  girl  started  right.  She  did  not  know  how  to  take  active 
steps  to  help  her  maid,  and  so  did  the  one  passively  kind  thing 
that  presented  itself. 

A  medical-social  worker  had  occasion  to  consult  a  former  employer  of  one  of  her 
patients  about  the  patient’s  insurance.  The  employer  denied  any  knowledge  of  it, 
though  the  insurance  records  showed  his  signature  to  payments.  Here  was  an 
honorable  man  making  a  false  statement.  He  explained  later  that  he  had  promised 
his  employe  not  to  tell  about  the  insurance.  The  denial  was  due  to  what  he  re¬ 
garded  as  the  demands  of  loyalty. 

Of  course,  the  social  worker  cannot  ask  that  witnesses  violate  their 
own  standards  of  ethics.  These  instances  show  a  kindheartedness 
that  no  one  would  wish  less.  In  the  last  illustration,  however,  what 
was  presumably  good  nature  led  the  employer  to  make  a  promise 
which  was  obviously  futile. 

3.  The  Bias  of  Self-interest.  This  form  of  bias  is  of  course 
universal.  When,  therefore,  a  witness  testifies  reluctantly  and 
apparently  against  his  interest,  his  testimony  has  special  weight. 

A  charity  organization  secretary  was  interested  in  a  family  consisting  of  a  wid¬ 
ower  and  four  children  under  fifteen.  These  children  came  to  the  office  one  day, 
saying  that  their  father  when  drunk  had  turned  them  out  of  doors,  and  that  they 
had  spent  the  night  with  a  cousin.  The  secretary  called  at  once  on  this  cousin, 
finding  his  wife  at  home  and  himself  in  bed  in  the  next  room.  The  wife  said  nothing 
except  that  the  children  had  been  there  as  they  said.  The  next  day  the  secretary 
called  again  and  found  the  woman  alone.  This  time  she  said  she  had  not  dared  to 
talk  openly  on  the  previous  day,  because  her  husband  would  not  approve  of  her 
saying  things  about  his  uncle.  The  uncle,  the  children’s  father,  was  drunk  most 

76 


4 


TESTIMONIAL  EVIDENCE 


of  the  time.  Although  the  children  should  be  taken  away,  she  could  not  go  to 
court  about  it.  Her  husband,  too,  drank  and  often  beat  her.  She  did  not  dare 
complain  about  this  even  to  her  own  relatives,  because  her  husband  had  said  that 
he  would  kill  her  father  and  brother  if  she  did. 

This  evidence,  given  under  circumstances  that  warrant  one’s  be¬ 
lieving  that  the  woman  had  nothing  to  gain  and  possibly  much  to 
lose  by  telling  it,  carries  a  strong  presumption  of  truth. 

The  suppression  of  facts  from  a  desire  to  escape  work  and  receive 
assistance  instead  is  a  fairly  obvious  form  of  self-interest.  The 
following  is  the  only  illustration  of  this  particular  fault  that  need 
be  given: 

An  Italian  girl  of  thirteen  was  referred  to  a  medical-social  department  for  gen¬ 
eral  hygiene.  There  were  two  younger  children,  the  mother  was  dead,  the  father 
out  of  work,  the  home  wretched.  A  young  man  living  there  was  said  by  the  pa¬ 
tient  to  be  her  cousin.  The  relationship  was  so  described  by  the  public  relief 
officials,  the  school  teacher,  and  the  Italian  society — all  of  which  seemed  to  be  con¬ 
firmatory  evidence.  But  a  priest  who  was  seen  thought  that  the  young  man  was 
a  brother,  and,  as  a  matter  of  fact,  he  was.  All  of  the  other  agencies  had  taken  the 
statement  from  the  family — a  first-hand  source  but  not  a  disinterested  one.  Rela¬ 
tives  not  living  with  the  family  group  told  the  truth,  and  proof  of  the  brother's 
responsibility  for  support  was  taken  into  court,  with  the  result  that  both  father 
and  son  were  induced  to  go  to  work. 

A  less  evident  form  of  self-interest,  or  of  what  the  witness  thinks 
is  such,  is  the  impulse  to  gratify  some  strong  emotion.  For  in¬ 
stance,  a  young  unmarried  mother  with  an  unfortunate  past 
wrongfully  accused  a  former  lover  of  being  the  father  of  her  child, 
because  she  wanted  to  pay  him  back  for  an  old  score.  Again,  an 
exasperated  mother  applied  to  an  agency  to  get  them  to  make  her 
stubborn,  lazy  daughter  work  and  be  obedient.  She  said  she  could 
do  nothing  with  the  girl.  It  turned  out  that  the  mother  drank,  had 
always  abused  her  daughter,  and  was  herself  immoral.  The  like¬ 
lihood  seemed  to  be  that  she  made  the  complaint  partly  because 
she  wanted  the  girl  to  support  her  and  thought  to  get  this  through 
the  society’s  supervision,  and  partly  because  she  feared  that,  once 
die  daughter  was  no  longer  as  amenable  to  authority  as  when  a 
child,  her  younger  attractions  might  alienate  the  affection  of  a 
man  who  had  been  living  with  the  mother. 

Self-interested  bias  also  shows  itself  in  another  form,  in  indi¬ 
vidual  or  collective  self-esteem.  An  ex-probation  officer  states 

77 


SOCIAL  DIAGNOSIS 


that  when  she  has  asked  girl  shoplifters  from  respectable  families 
how  they  happened  to  do  such  a  thing,  again  and  again  she  has 
met  the  reply,  “  I  don’t  know  what  got  into  me.”  Her  acquaintance 
with  such  girls  satisfied  her  that  they  had  not  thought  of  shoplift¬ 
ing  as  a  serious  offense  against  the  law.  It  had  seemed  to  them  a 
peccadillo,  something  rather  smart  to  put  through  without  detec¬ 
tion,  like  stealing  a  car  ride.  When  they  found  themselves  behind 
prison  bars,  they  were  shocked  to  see  themselves  without  illusion 
as  thieves,  under  disgrace.  They  had  never  intended  to  be  that; 
they  had  thought  of  themselves  as  being  far-removed  from  the 
criminal  class.  After  release,  their  rallying  self-esteem  led  them  to 
the  half-expressed  feeling  that  it  was  not  their  real  self  that  had 
committed  a  crime. 

Collective  self-esteem  appears  frequently  as  family  pride. 

The  secretary  of  a  charity  organization  society  interviewed  the  brother  and 
sister-in-law  of  a  deserted  wife  who  was  asking  relief  for  herself  and  children. 
The  brother  blamed  his  sister’s  husband  for  being  “no  good,”  and  for  not  support¬ 
ing  his  family,  but  could  offer  no  suggestions  as  to  future  plans.  His  wife,  how¬ 
ever,  advised  boarding  the  children  out  on  the  ground  that  their  mother  could  not 
go  out  to  work  and  at  the  same  time  care  for  them. 

A  former  landlord  also  condemned  the  husband,  saying  that  while  the  deserted 
wife  lived  in  his  house  she  had  taken  excellent  care  of  it  and  paid  her  rent  regularly. 
He  did  not  consider  it  her  fault  that  the  man  deserted.  Although  this  landlord  had 
heard  that  sh£_wertjt  to. town  with  men,  he  did  not  regard  her  as  vicious.  She  un¬ 
doubtedly  needed  the  money,  since  she  never  seemed  strong  enough  for  work. 

With  further  inquiry,  more  evidence  came  to  light  of  this  mother’s  wrong-doing. 
The  secretary  then  went  again  to  the  sister-in-law  who,  finding  the  woman’s  char¬ 
acter  known,  testified  that  the  husband  had  been  away  many  years,  that  the  last 
two  children  were  not  his,  but  were  the  offspring  of  two  different  men,  the  last  of 
whom  was  paying  the  woman  an  allowance  and  still  living  with  her  from  time  to 
time.  The  court  removed  these  three  children  from  the  mother. 


The  family  pride  which  led  the  brother  and  sister-in-law  in  this  case 
to  withhold  the  truth  in  the  first  place  was  of  course  a  feeling  one 
must  respect,  however  disastrous  its  possible  results  to  the  children 
involved  or  however  annoying  it ‘may  be  to  a  busy  worker.  They 
had  never  seen  the  worker  before  and  perhaps  could  not  judge  how 
carefully  he  would  guard  confidences  or  how  much  power  or  in¬ 
terest  he  might  have  in  remedying  a  bad  situation.  The  landlord’s 
bias  was  twofold.  His  standards  of  conduct  were  evidently  easy, 

78 


TESTIMONIAL  EVIDENCE 


inclining  him  to  be  tolerant  beyond  reason,  and  his  interests  as  a 
landlord  prejudiced  him  in  favor  of  a  good  tenant. 

There  is  a  bias  of  self-esteem  to  which  social  workers,  especially 
the  clever  or  informed  ones,  may  themselves  become  liable.  A 
desire  to  be  thought  penetrating  may  lead  them  to  interpret  facts 
of  conduct  with  over-subtlety;,  to  see  a  certain  motive  where  it  does 
not  exist.  To  such  over-subtlety  the  social  worker  is  tempted  in 
dealing  with  a  case  of  the  following  type:  She  learns  that  a  man’s 
relatives  have  habitually  characterized  his  marriage  as  a  very  good 
match  on  his  wife’s  part.  Learning  further  that  the  husband  has 
never  told  his  family  of  his  wife’s  capability  as  a  manager,  she  in¬ 
terprets  these  facts  to  mean  that  the  man  has  not  wanted  to  modify 
his  family’s  flattering  partiality  of  judgment  towards  himself.  This 
inference  on  the  worker’s  part  might  easily  spring  from  vanity  at 
her  astuteness,  rather  than  from  unbiased  reasoning.  As  is  true 
of  all  prejudice,  the  cure  of  this  bias  lies  in  becoming  aware  of  it. 

Finally,  this  discussion  of  testimonial  evidence  should  not  close 
without  the  further  warning  that  there  is  always  danger — though 
the  danger  here  is  greatest  for  the  beginner  in  social  work — in  the 
attempt  to  substitute  the  results  of  formulated  experience  for  our 
own  unguided  impulses.  We  may  easily  become,  for  a  time  at 
least,  hypercritical.  The  new  worker,  while  throwing  himself  with 
enthusiasm  into  the  task  of  mastering  a  new  discipline,  may  lose 
his  perspective.  “The  extreme  of  distrust  in  these  matters,”  says 
Langlois,  “is  almost  as  mischievous  as  the  extreme  of  credulity.” 
The  case  worker’s  best  safeguard  against  formalism  and  skepti¬ 
cism  is  a  concern  for  the  interests  of  his  client. 

SUMMARY  OF  THIS  CHAPTER 

1.  The  two  factors  which  condition  the  value  of  a  witness’s  testimony  are  his 
competence  and  his  bias.  Competence  includes  both  the  witness’s  opportunity  to 
know  the  facts  and  the  way  in  which  he  has  used  this  opportunity.  Bias  includes 
those  ideas  and  emotions  of  the  witness  which  may  prejudice  his  judgment. 

2.  A  witness  frequently  thinks  he  has  had  ample  opportunity  to  know  the  facts 
when  the  reverse  is  the  case.  The  use  which  a  witness  has  made  of  his  opportunity 
to  know  the  facts  is  conditioned  by  his  powers  of  attention  and  memory,  and  by 
his  suggestibility. 

79 


4 


-  ■  '■ 

\  \ 

3 

V  Vi  :" 

SOCIAL  DIAGNOSIS 

3.  Closeness  of  attention  to  an  incident  depends  in  part  upon  the  importance 
attached  to  it  at  the  time,  and  in  part  upon  the  stock  of  ideas  or  “funded  thought” 
of  the  observer. 

4.  The  time  at  which  an  event  took  place  is  often  recalled  by  associating  it  with 
some  other  event  the  date  of  which  is  already  known.  It  is  characteristic  of  mem¬ 
ory  material  that  it  deteriorates  with  repetition.  The  first,  unrehearsed  statement 
of  a  witness  is  often  the  most  trustworthy. 

5.  An  over-readiness  to  yield  assent  to  or  reproduce  the  assertions  of  others 
often  impairs  the  value  of  a  witness’s  testimony.  Such  suggestibility  may  even 
lead  to  mistaken  confessions. 

I  6.  Closely  related  to  this  characteristic  of  suggestibility  is  the  danger  involved 
in  asking  “leading  questions.”  It  is  not  always  possible  to  avoid  them,  but  the 
case  worker  can  at  least  cultivate  a  watchful  eye  for  their  use,  so  that  he  shall  not 
be  betrayed  into  accepting  back  as  fact  what  he  has  himself  suggested  by  the  form 
of  his  query. 

7.  The  commonest  forms  of  bias  encountered  in  social  work  are  racial  or 
national  and  environmental  bias,  and  the  bias  of  self-interest.  Collective  self¬ 
esteem,  one  form  of  which  is  family  pride,  may  be  classified  under  this  last-named 
head. 


I1 


CHAPTER  V 


INFERENCES 

FORMAL  treatment  of  the  processes  of  reasoning  is  not 
within  the  scope  of  this  book.  The  application  of  those  proc¬ 
esses  to  social  diagnosis,  however,  will  appear  in  brief  illus¬ 
trations  of  ways  in  which  a  case  worker’s  inferences  (justifiable  or 
not),  his  conscious  or  unconscious  assumptions,  and  his  predis¬ 
positions  help  or  hinder  his  diagnosis  of  a  client’s  situation.  An 
understanding  of  a  client’s  difficulties,  like  any  advance  in  knowl¬ 
edge,  comes  from  the  interplay  of  two  methods;  namely,  that  of 
direct  testimony  to  facts  in  his  life — treated  in  the  two  preceding 
chapters — and  that  of  inference  from- these  facts  to  others  that  are 
unknown. 

I.  HOW  INFERENCE  IS  MADE 

Inference,  then,  a  passing  from  known  to  unknown  facts,  is  the 
reasoning  process — most  familiar  when  it  takes  the  form  of  draw¬ 
ing  a  conclusion  from  the  relation  existing  between  a  general  truth 
and  a  particular  instance.  It  may,  however,  proceed  from  many 
particular  cases  to  a  general  rule,  as  well  as  from  a  rule  to  some  new 
fact  about  a  particular  case.  Reasoning  from  particular  cases  to 
the  general  rule  is  shown  in  the  following  brief  passages  taken  from 
The  Charity  Visitor:1 

A  knowledge  of  the  number  of  rooms  occupied  is  necessary  in  order  to  determine 
whether  the  family  is  living  under  dangerously  overcrowded  conditions,  either  from 
a  physical  or  from  a  moral  standpoint. 

The  constantly  shifting  family  is  certainly  in  need  of  some  kind  of  assistance. 
.  .  .  Also  the  fact  of  a  change  of  residence  suggests  some  reason  for  change, 

which  is  often  a  salient  factor,  particularly  when  the  change  is  from  one  section  of 
the  city  to  another  or  from  one  city  to  another. 

The  membership  of  a  man  in  a  labor  union  is  in  itself  an  indication  that  he  is  a 
workman  and  associates  with  workmen;  if  his  “card  is  clear,"  that  is,  if  he  is  in 
good  standing  and  his  dues  are  paid  up,  there  is  further  assurance  of  his  reliability. 

1  The  Charity  Visitor,  Amelia  Sears,  pp.  23,  26-27,  35. 

8l 


6 


SOCIAL  DIAGNOSIS 


Here  are  three  general  rules  familiar  to  the  case  worker  which 
are  inferences  from  a  large  number  of  instances  (i)  of  the  effect 
of  an  insufficient  number  of  rooms,  (2)  of  the  significance  of  a 
family’s  constantly  shifting,  and  (3)  of  a  man’s  membership  in 
union.  The  validity  of  each  of  these  rules  depends  upon  the  acc 
racy  with  which  the  particular  instances  from  which  the  rule  was 
inferred  were  noted,  upon  the  number  and  essential  similarity  of 
these  instances,  and  upon  the  absence  of  exceptions. 

Reasoning  from  a  rule  to  some  new  fact  about  a  particular  case 
is  illustrated  by  this  item  taken  from  our  case  reading: 


A  man  with  a  record  of  drink  owed  a  bill  to  a  hospital.  Its  social  worker  learned 
from  the  cashier  at  the  patient’s  place  of  business  that  he  had  recently  received  a 
considerable  sum  of  money  for  accident  insurance.  The  inference  drawn  was  that 
he  could  pay  his  hospital  bill. 


The  implied  general  truth  of  which  this  case  appeared  to  be  an 
instance  is  that  “  People  who  have  money  enough  on  hand  can  pay 
their  debts.”  It  is  obvious  that  without  this  general  truth  in  the 
background  of  one’s  mind  the  above  inference  could  not  be  drawn 
and  the  man’s  having  or  not  having  received  money  would  bear 
no  meaning  for  us.  On  the  other  hand,  how  did  we  get  our  dictum 
that  people  who  have  money  can  pay  their  debts?  This  rule  is  an 
inference  drawn  from  innumerable  particular  cases  to  this  effect 
that  have  occurred  within  everyone’s  experience. 

It  is  evident,  then,  that  in  reasoning  one  must  be  prepared  to 
support  the  conclusion  by  reassuring  a  doubter  at  either  or  both 
of  two  points.  The  doubter  may  challenge  it  by  asking  either, 
(1)  Is  the  rule  appealed  to  strictly  true?  or  (2)  Is  the  given  instance 
really  a  particular  case  of  that  rule? 

A  critic  of  a  case  record  writes,  “  I  infer  that  there  must  be  some  resource  not 
discovered,  as  a  family  of  seven  could  hardly  have  subsisted  for  three  months  on 
those  grocery  orders  from  the  city  only,  even  if  the  milk  mentioned  May  7  con¬ 
tinued.  I  conclude  it  did  not,  since  there  is  a  new  application  for  it  in  August.” 

The  general  rule  implied  in  the  first  inference  in  this  case  is  stated 
here,  namely,  that  a  family  of  seven  cannot  live  on  the  usual 
public  relief  order.  The  rule  implied  in  the  second  inference  is 
that  people  do  not  apply  for  the  same  aid  from  the  same  source 
while  they  are  already  receiving  it.  As  was  true  in  the  preceding 
case,  both  these  rules  are  in  turn  inferences  drawn  from  many 

82 


INFERENCES 


particular  instances  in  the  past  (i)  of  the  minimum  diet  which  can 
sustain  life,  and  (2)  of  the  habits  of  rational  beings. 

A  child  had  been  returned  to  its  home  from  a  hospital,  and  it  had  become  neces¬ 
sary  to  learn  whether  malnutrition  was  due  to  unwise  diet  in  the  home  or  to  the 
straitened  circumstances  of  the  family.  The  record  of  the  medical-social  depart¬ 
ment  making  the  inquiry  reads:  “  Family  have  two  extra  rooms  which  they  are  not 
trying  to  rent  to  lodgers.  If  in  straitened  circumstances  this  would  not  be  the  case.” 

Is  the  general  rule  sound  on  which  the  inference  in  this  case  is 
based;  namely,  that  families  in  straitened  circumstances  rent  their 
extra  rooms?  That  depends,  as  before  stated,  upon  how  many 
instances  of  this  have  been  observed,  and  upon  the  accuracy  of  the 
observation. 

In  the  process  of  our  investigation  of  a  case,  an  inference  may 
pass  through  various  stages  of  certainty.  Its  first  stage  is  often 
tentative.  It  is  a  hypothesis,  a  possibility  to  be  proved  or  dis¬ 
proved  by  further  evidence.  In  a  first  interview,  for  instance,  the 
skilful  worker  forms  many  hypotheses,  holding  some  for  the  con¬ 
firmation  of  further  evidence,  accepting  a  few  as  proven  by  the 
evidence  before  him,  and  discarding  others  as  the  interview  pro¬ 
ceeds. 

To  illustrate  this  a  case  worker  recommends  trying  the  experi¬ 
ment  of  removing  the  “face  card”  (sheet  of  information  in  tabular 
form  at  the  beginning  of  a  case  record)  from  the  unread  history 
sheets  and  drawing  from  the  card  alone — see  the  one  for  the  Ames 
family  reproduced  on  the  following  page — a  series  of  inferences. 
This  worker  regards  such  an  exercise  as  good  drill  for  a  beginner, 
since  it  approximates  the  mental  processes  he  should  go  through 
in  making  an  investigation.  From  the  fact  given  on  the  Ames 
face  card  that  this  family  of  five  lived  in  six  rooms  at  a  rental  equal 
to  their  highest  weekly  wage,  the  worker  in  question  inferred  that 
they  had  a  fairly  high  home  standard.  Had  she  made  this  infer¬ 
ence  in  the  course  of  her  interview  with  the  family,  she  would  have 
gone  on  to  confirm  it  by  inquiring  whether  they  had  had  or  ex¬ 
pected  to  have  lodgers  or  whether  they  had  taken  the  house  merely 
through  inertia  because  it  was  the  first  decent  one  they  had  lighted 
on,  etc.  If  the  family's  statement  barred  out  these  other  explana¬ 
tions  and  fell  in  with  her  inference,  she  would  accept  the  latter 
as  a  fact.  Again,  the  worker  learned  from  the  face  card  that  four 

83 


SOCIAL  DIAGNOSIS 


FACE  CARD 


Surname  Ames 

Date  5- 1 0-09 

Date 

Address 

Rent  per  Mo. 

Rms. 

5- 1 0-09 

1906  Rodman  St.  $12 

6 

First  Name 

Age  Date  of  Birth  Occ.  or  School 

Phys.  Defects 

Man’s 

1  Thomas 

38 

Hatter 

Tuberculosis 

IVoman’s  Maiden 

2  Jane 

28 

Children 

3  Alice 

2-1903  McArthur  Sch. 

4  Susan 

6-1907 

Others  in  Family 

Kinship 

To  No. 

Bdr.  or  Ldgr. 

5  Mrs.  Maxwell 

Mother 

2  50c.  wk.  for  rm. 

Birthplace 

Nationality 

Religion 

Benefit  Socy. 

1  Eng. 

Eng. 

Bapt. 

2  U.  S. 

Scotch 

<  c 

Benefit  Order 

Relatives  not  Living 

in  Family 

Address  Kinship 

To  No. 

Joseph  Ames 

16  Carpenter  St.  bro. 

1 

Clara  Ames 

1408  Coxton  St.  sis. 

1 

Abel  Ames 

1408  Coxton  St.  bro. 

1 

Mrs.  Abington 

3 1 1  2d  St.  sis. 

1 

Mrs.  Arthur  Brown 

1705  Alden  St.  sis. 

2 

Mrs.  Freeman 

901  First  St.  sis. 

2 

Churches  Interested 

Medical  Agencies  Interested 

In  No. 

Tenth  Bapt.  Church, 

Dr.  Johnson,  300  Webster  Ave.  1,  2 

Rev.  Mr.  Gleason, 

N.  W.  Tbc.  Dispensary 

1 

7301  Clark  St. 

State  Sanatorium 

1 

Dr.  Lane,  65  Dean  St. 

3.  4 

Of  No.  Employers 

Position  IV  hen 

Weekly  Earnings 

1  Caldwell’s  hat  factory 

Work  on  furs  1901-09 

$12~$8 

5  Boxton  Hotel 

1  Moran’s 

Installment  House  Canvassing  3-1910 

1  Caldwell’s  hat  factory 

Doorman  4-19 10 

Date 

Referred  by 

Address 

5-10-09 

Miss  Delancey 

1616  Upton  St. 

Friendly  Visitor  Address 

Miss  Delancey  1616  Upton  St. 

84 


INFERENCES 


years  elapsed  between  the  births  of  Mrs.  Ames’  two  children. 
This  may  mean  miscarriages  or  the  death  of  infants,  either  of  which 
may  have  been  the  cause  or  the  result  of  low  vitality  in  the  mother. 
Putting  such  an  inference  together  with  the  fact  of  the  man’s  being 
tuberculous  (experience  with  the  reluctance  of  workingmen  to  yield 
to  sickness  warrants  the  hypothesis  that  this  man’s  condition  is 
fairly  advanced)  and  of  physicians’  having  been  consulted  for  both 
the  wife  and  the  children,  the  investigator  makes  the  hypothesis 
that  the  family  health  is  poor.  If  she  were  interviewing  these 
people  she  would  at  once  try  to  get  at  a  few  simple  medical  facts, 
such  as  an  intelligent  layman  can  ascertain  and  such  as  would 
indicate  whether  she  should  ask  medical  advice.  The  use  of  the 
hypothesis  to  the  social  worker  in  the  case  is  to  stimulate  his  col¬ 
lection  not  only  of  the  medical  facts  indicated  but  of  relevant 
social  evidence  as  well;  namely,  the  ventilation  and  heating  of  the 
family’s  rooms,  the  warmth  of  their  clothing,  their  exercise,  their 
diet,  including  the  wife’s  ability  as  a  cook.  In  this  instance,  it 
would  be  the  physician  and  not  the  social  worker  who  would  estab¬ 
lish  or  disprove  the  hypothesis  of  delicate  health  in  the  family. 
Many  other  inferences  occur  to  one  from  this  face  card;  namely, 
that  the  man  came  to  this  country  before  marriage,  that  he  was 
probably  married  in  1901  or  1902,  that  his  work  was  unskilled  al¬ 
though  he  must  have  been  acceptable  to  his  employer,  and  so  on. 
His  coming  to  this  country  before  marriage  might  perhaps  be  con¬ 
sidered  a  safe  enough  inference  without  more  evidence;  the  two 
latter  inferences  call  for  confirmation. 

II.  HOW  INFERENCE  IS  CORROBORATED 

In  the  illustration  on  p.  83,  the  inference  that  the  family  is  not 
in  straitened  circumstances  because  no  effort  is  being  made  to 
rent  extra  rooms,  resting  as  it  does  on  a  rule  open  to  occasional 
exception,  should  in  justice  to  the  family  in  question  be  subjected 
to  the  test  of  further  evidence.  A  woman  whose  husband  was  sick 
and  away  was  found  to  have  allowed  a  man  lodger  to  give  her  a 
black  eye  without  any  resentment  on  her  part.  The  inference — 
or  hypothesis — dr?wn  from  this  fact  as  to  the  undue  intimacy  of 
their  relations  v,as  confirmed  by  further  evidence. 

Confirming  evidence  may  be  gathered  deliberately  for  the  pur- 


SOCIAL  DIAGNOSIS 


pose  of  confirmation  or  it  may  be  evidence  lying  in  our  past  experi¬ 
ence.  The  professional  experience  of  social  workers  makes  them 
recognize  a  recurring  relation  between  the  number  of  rooms  occu¬ 
pied  and  the  health  and  decency  of  the  occupants;  between  a  man's 
trade  union  record  and  his  record  as  a  worker;  between  the  size 
of  a  family  and  the  minimum  amount  of  food  they  can  live  on; 
or  between  a  family’s  income  and  their  having  extra  rooms  un¬ 
rented,  etc.  Although  none  of  these  relations  are  fixed  for  all  time, 
the  richer  the  experience  of  the  worker  in  supplying  him  with  such 
fairly  constant  rules,  the  greater  is  the  variety  of  hypotheses  to 
which  such  experience  can  give  rise,  and  therefore  the  more  likely 
is  he  to  light  upon  the  hypothesis  which  will  prove  correct. 

What  workers  sometimes  complacently  term  their  intuitions  are 
often  merely  rapid  inferences  based  on  experience.  A  case  in  point 
is  the  following: 

A  medical-social  worker  was  explaining  that  she  had  learned  to  trust  her  intui¬ 
tions.  When  asked  for  instances  of  what  she  meant  by  intuitions  she  replied,  “A 
man  was  referred  to  me  not  long  ago  whom  I  classified  as  a  jailbird  at  once,  and 
sure  enough  I  found  that  he  had  a  long  record  at  our  county  prison.”  Further 
questioning  revealed  this  process  of  reasoning:  “The  man  was  an  Irishman  and  had 
been  in  this  country  twenty-two  years,  but  had  never  been  naturalized,  which  struck 
me  as  shiftless  for  a  man  of  his  nationality.  That  made  me  sure  that  he  had  some 
reason  for  not  wanting  to  vote  or  that  he  was  prevented  from  doing  so  by  a  criminal 
history.” 

The  intuition  was  an  inference,  a  hypothesis  which  the  worker’s 
experience  suggested  and  which  served  to  lead  her  to  a  search  for 
confirming  evidence  in  the  public  records.  It  is  of  course  possible 
that  the  man’s  appearance  played  an  unrecognized  part  in  the 
forming  of  this  hypothesis. 

Occasionally,  because  of  gaps  in  evidence,  confirmation  of  a 
hypothesis  has  to  be  sought  through  experiment.  Such  evidence 
is,  for  the  purposes  of  social  case  work,  far  from  satisfactory,  be¬ 
cause  in  dealing  with  human  material  experiment  is  controlled 
with  difficulty.  If  we  send  to  the  charity  woodyard  an  Italian 
whose  work  references  are  inaccessible  and  he.  leaves  the  work  after 
a  short  stay,  is  he  lazy,  or  is  he  incapabl*  of  adapting  himself 
quickly  to  the  changed  conditions  of  work  wirh  a  foreman  who  does 
not  understand  Italians,  and  with  fellow  work*  ten  who  do  not 
speak  his  language,  etc.?  “The  one  great  difficulty/'  says  Alfred 

86 


INFERENCES 


Sidgwick,1  “is  that  of  making  sure  that  when  we  introduce  A 
[laziness]  into  a  given  set  of  circumstances  nothing  else  comes  in 
along  with  it,  or  directly  after  it,  or  is  already  there  unknown  to  us. 
For  if  another  detail,  Z,  [the  difficulty  of  getting  on  with  an  Ameri¬ 
can  foreman,  among  other  things]  has  crept  in  thus  insidiously, 
the  experiment  fails  to  show  that  it  is  A  rather  than  Z  to  which 
the  effect  is  due.” 

There  is  a  satisfaction  beyond  the  establishing  of  a  certain 
number  of  required  facts  for  those  who  have  or  acquire  the  insight 
to  make  such  tentative  inference.  These  inferences  are  a  means 
of  leading  us  from  the  comparatively  few  known  facts  about  any 
client  to  some  of  the  many  unknown  ones  which  a  personal  social 
problem  always  contains,  as  well  as  a  means  of  guiding  our  inves¬ 
tigation  into  fruitful  channels.  Evidence  gathered  to  corroborate 
or  disprove  a  theory,  to  combine  new  facts  with  those  previously 
known,  thus  becomes  a  creative  thing;  whereas  facts  collected 
mechanically  item  by  item  to  fill  out  a  schedule  or  meet  a  minimum 
requirement  of  some  sort  lack  the  interrelation  that  would  give 
them  significance.  They  give  but  a  sketchy  outline  of  a  client’s 
needs.  When  evidence  is  meager,  ingenuity  in  the  making  of  one 
working  hypothesis  and  then  another  and  patience  in  trying  them 
out  by  experiment  may  be  the  only  way  of  arriving  at  the  truth. 
As  we  proceed  with  our  inquiry  and  get,  from  the  accumulating 
facts  and  from  the  use  of  these  in  testing  our  successive  hypotheses 
and  inferences,  the  evidential  material  for  accurate  diagnosis, 
reasoned  knowledge  gradually  takes  the  place  of  hypothesis. 

In  making  an  advance  in  knowledge,  whether  in  law,  science, 
or  social  work,  certain  risks  are  involved.  Those  contained  in 
erroneous  testimony  have  been  discussed  in  the  preceding  chapter. 
Assuming  then  that  our  testimony  is  reliable,  there  are  still  risks 
that  arise  (i)  from  the  process  of  thinking,  or  (2)  from  the  thinker’s 
state  of  mind. 

III.  THE  RISKS  INVOLVED  IN  THINKING 

The  risks  in  the  process  of  thinking  may  occur  in  four  ways;  we 
may  have  a  mistaken  general  rule,  a  mistaken  particular  case,  a 
mistaken  analogy,  or  a  mistaken  causal  relation. 

1  Application  of  Logic,  p.  91. 

87 


SOCIAL  DIAGNOSIS 


1.  Mistaken  General  Rule.  Suppose  that  in  the  case  cited  on 
p.  86  we  infer  that  the  Italian  in  question  is  lazy.  We  thereby 
imply  that  as  a  general  rule  needy  men  who  refuse  to  work  at  the 
charity  woodyard  are  lazy.  There  are,  however,  frequent  excep¬ 
tions  to  this  rule,  other  explanations  of  a  man’s  refusing  such  work. 
Therefore  the  general  rule  is  open  to  question,  and  the  inference 
in  the  particular  case  is,  as  a  consequence,  of  doubtful  validity. 

Again  take  the  case  of  James  Smith,  who  withholds  the  name  of 
his  present  employer.  May  we  say  “  as  a  general  rule,  the  man  who 
puts  obstacles  in  the  way  of  consulting  his  employer  is  a  man  with 
a  poor  work  record”  and  draw  the  inference  that  James  Smith 
wants  to  conceal  his  inefficiency?  Hardly.  Here  too  there  are  so 
many  possible  reasons  besides  the  one  given  for  such  an  unwilling¬ 
ness  on  the  part  of  employes  that  we  must  apply  this  general  rule 
only  with  great  caution. 

Couples  who  are  married  have  neither  embarrassment  nor  hesitancy  in  giving 
this  information  [i.  e.,  date  and  place  of  marriage]  unless  they  are  purposely  with¬ 
holding  facts  of  early  life.1 

“It  is  quite  conceivable,”  writes  a  critic  of  this  statement,  “that  the  question 
might  have  been  asked  as  if  it  were  an  accusation  that  the  couple  interviewed  were 
not  married,  or  that  it  might  have  been  so  taken  by  a  hypersensitive  person.  Such 
an  apparent  attitude  of  suspicion  does  not  always  bring,  in  return,  the  proof  wanted 
and  producible;  it  sometimes  brings  instead  a  stubborn  refusal,  or  else  the  informa¬ 
tion  is  given  with  real  embarrassment.  Also  (2)  clients  may  honestly  not  remember 
the  date  and  the  year,  or  (3)  they  may  consider  it  unimportant  and  not  germane 
to  their  present  situation.”  2 

Therefore  this  general  rule  is  untrustworthy  and  reasoning  which 
depended  upon  it  would  be  invalid.  In  the  case  of  the  Browns, 
who  hesitated  when  asked  for  the  information,  you  could  not  in¬ 
fer  such  concealment  with  any  certainty. 

1  The  Charity  Visitor,  p.  21.  Some  excellent  examples  of  sound  inference  have 
already  been  given  from  Miss  Sears’  pamphlet.  In  the  attempt,  however,  to  formu¬ 
late  generalized  statements  applicable  to  given  combinations  of  case  work  circum¬ 
stance,  there  is  always  the  danger — a  danger  which  the  present  volume  illustrates 
too,  probably — of  assuming  that  in  no*  case  can  the  outer  fringe  of  circumstance  not 
specifically  included  in  the  combination  make  another  conclusion  necessary.  The 
inference  quoted  above  and  a  few  others  that  follow,  taken  from  The  Charity 
Visitor,  illustrate  this  risk. 

2  For  some  of  the  comments  quoted  in  this  part  of  the  chapter,  the  author  is 
indebted  to  a  group  of  former  students,  especially  to  Miss  Marion  Bosworth  and 
Miss  Ruth  Cutler. 


88 


INFERENCES 


A  definite  statement  of  the  floor  and  the  part  of  the  house  in  which  the  family 
lives  .  .  .  indicates  .  .  .  economic  status,  the  probable  sanitary  condi¬ 

tion  of  the  home,  and,  taken  in  comparison  with  the  part  of  the  house  at  a  previous 
address,  the  advancement  or  deterioration  of  the  family  fortunes.1 

Has  it  been  the  common  experience  of  social  workers  that  knowl¬ 
edge  of  the  floor  and  the  part  of  the  house  in  which  a  family  lives 
indicates  these  three  distinct  conditions? 

A  case  worker  suggests  the  following  exceptions:  A  family  may  have  risen 
economically  above  its  rooms  or  neighborhood  but  be  held  there  by  some  tie  of 
kinship,  nationality,  sentiment,  or  by  accustomedness  and  inertia.  Or  a  family’s 
idea  of  thrift  may  lead  them  to  deprive  themselves  and  their  children  of  what  we 
consider  necessities  in  order  to  keep  a  bank  account  intact.  Or  again,  inconvenient 
rooms  may  be  in  an  exceptionally  favorable  location,  near  the  work  of  some  member 
of  the  family,  near  a  church,  a  settlement,  a  day  nursery,  etc.  As  regards  the  rela¬ 
tion  suggested  between  “floor”  and  “sanitary  conditions”  experience  does  not  bear 
it  out.  The  comparison  suggested  with  a  “previous  address”  might  mean  nothing, 
but  on  the  other  hand  comparison  with  a  series  of  such  addresses  would  probably 
have  significance. 

In  short,  this  rule  is  subject  to  so  many  exceptions  or  qualifications 
that  we  can  but  regard  it  as  mistaken.  When,  then,  we  find  a 
family  living  in  a  third  floor  back  on  Y  Street  we  cannot  from  that 
infer  their  income  and  the  sanitation  of  their  home. 

The  following  rule  is  evidently  of  doubtful  validity,  since  it 
holds  good  only  with  certain  exceptions:  * 

Information  concerning  the  school  opportunities  of  any  illiterate  person  should 
be  most  carefully  gathered  and,  unless  the  history  shows  a  gross  exploitation  of  the 
individual  that  more  than  accounts  for  his  illiteracy,  it  is  advisable  to  have  the 
mental  ability  of  the  illiterate  person  tested.2 

As  regards  those  who  come  from  states  where  there  is  or  has  been 
no  compulsory  education  law  and  as  regards  foreigners  this  rule 
should  be  more  tentatively  stated.  Lack  of  opportunity  and  lack 
of  compulsion  have  made  illiteracy  common  among  some  of  them 
— among  the  Galician  farmers,  for  instance. 

The  mere  statement  of  the  age  and  the  grade  of  the  child  is  of  value  in  showing 
whether  or  not  he  is  a  retarded  child.  If  he  is  below  his  grade,  a  special  effort  must 
be  made  to  ascertain  whether  he  is  backward  merely  as  a  result  of  bad  environment, 
neglect,  physical  condition,  or  irregularity  of  attendance,  or  whether  he  is  a  mental 
defective.3 

1  The  Charity  Visitor,  p.  23. 

2  The  Charity  Visitor,  pp.  34-35.  3  The  Charity  Visitor,  p.  32. 

89 


SOCIAL  DIAGNOSIS 


Here  the  various  possibilities  are  indicated,  thus  safeguarding  the 
statement  adequately. 

The  social  worker  must  bear  in  mind  that  the  “general  rules” 
that  enter  into  reasoning  in  the  field  of  human  conduct  can  never 
be  of  universal  application;  that  is,  they  will  all  be  liable  to  many 
exceptions.  This,  however,  does  not  disqualify  them  from  serving 
to  advance  knowledge  about  particular  cases.  For  instance,  if  75 
per  cent  of  the  couples  who  hesitate  to  give  information  about 
their  marriage  do  so  with  the  motive  of  concealing  discreditable 
facts,  the  worker  cannot,  it  is  true,  from  such  a  rule  deduce  with 
any  assurance  the  conclusion  that  a  given  reticent  couple  has  a 
scandal  to  conceal.  But  he  can  make  such  an  approximately  gen¬ 
eral  rule  the  basis  of  a  tentative  inference,  a  hypothesis,  which  will 
serve  as  a  guide  to  his  inquiry  into  the  past  life  of  a  given  couple. 
The  hypothesis  may  be  disproved  by  further  evidence,  the  couple 
in  question  turning  out  to  have  an  honorable  reason  for  reticence. 
Nevertheless,  it  is  the  worker’s  merely  tentative  inference,  based 
on  a  rule  of  only  partial  application,  which  will  have  been  the  first 
step  in  bringing  the  truth  to  light. 

2.  Mistaken  Particular  Case.  Since  an  inference  is  drawn  not 
from  a  general  rule  standing  by  itself,  but  from  such  a  rule  as  it  is 
applied  to  a  particular  case,  it  follows  that,  however  unimpeach¬ 
able  the  rule,  the  particular  case  may  not  come  under  it.  The  rule 
that  “the  constantly  shifting  family  is  certainly  in  need  of  some 
kind  of  assistance”1  may  be  accepted  by  all  social  workers.  If, 
however,  the  breadwinner  is  an  exhibitor  of  trained  dogs  who  takes 
his  wife  and  children  on  business  tours,  this  is  not  a  shifting  family 
in  the  sense  intended  in  the  rule.  The  term  shifting  family  at  once 
becomes  ambiguous  for  this  particular  case. 

Take  again  the  case  cited  on  p.  82  of  the  patient  who  was  in¬ 
ferred  to  have  been  able  to  pay  his  hospital  bill  because  he  had 
recently  received  an  accident  insurance.  The  rule  back  of  the  in¬ 
ference  was  that  people  who  have  money  enough  on  hand  can  pay 
their  debts — a  sound  enough  dictum.  The  first  assumption  was 
that  this  particular  patient’s  case  came  under  the  rule.  But  how 
did  it  turn  out?  The  man  on  being  questioned  produced  a  receipt 
for  the  board  of  his  children  which  had  just  been  paid.  The  sum 

1  The  Charity  Visitor,  p.  26. 

90 


INFERENCES 


amounted  to  almost  the  total  of  his  insurance.  The  particular  case, 
then,  was  different  from  what  it  was  first  supposed  to  be.  This  man 
was  not  a  person  with  money  on  hand.  The  case  did  not  fit  the  rule. 

Again  we  may  have  the  rule  “first  offenders  are  hopeful  subjects 
for  probation/’  In  a  given  instance,  however,  the  offender  may 
have  been  a  boy  who  had  been  pilfering  undetected  for  years  or  a 
girl  who  had  had  sexual  relations  with  boys  and  men  since  child¬ 
hood,  although  only  now  brought  to  court.  In  the  sense  intended 
by  the  general  rule  neither  of  these  is  a  first  offender. 

3.  Mistaken  Analogy.  Inference  is  often  drawn  by  what  ap¬ 
pears  to  be  an  analogy  between  some  one  case  under  consideration 
and  another  which,  in  those  respects  that  are  of  importance  for 
the  purpose  in  hand,  closely  resembles  it.  For  instance,  if  a  worker, 
knowing  of  a  number  of  cases  of  tuberculosis  among  hatters  who 
had  worked  in  the  same  factory  with  Ames,1  conceived  the  purpose 
of  attempting  to  render  more  sanitary  the  processes  of  the  hat 
trade,  he  would  look  for  a  probable  analogy  between  the  facts  of 
these  several  cases  and  of  men  in  other  hat  factories  as  to  working 
conditions,  incidence  of  the  disease,  etc.;  whereas  if  his  purpose 
were  to  get  Ames  himself  well  and  self-supporting,  he  would  look 
for  a  different  set  of  analogies  in  making  his  diagnosis  and  would 
emphasize  many  things  in  which  Ames  and  his  family  differed 
from  the  other  cases  of  tuberculosis  in  hat  factories. 

Again,  suppose  that  Mrs.  X’s  explanation,  that  the  beer  seen 
going  into  her  tenement  was  left  there  temporarily  for  a  neighbor, 
proved  to  be  a  falsehood.  A  worker  hearing  the  same  explanation 
offered  under  apparently  similar  circumstances  by  Mrs.  Y  might 
reason  by  analogy  that  this  was  the  same  old  excuse  and  that 
Mrs.  Y  like  Mrs.  X  was  a  drinking  woman.  Whereas,  if  he  inquired 
further  he  might  find  that  Mrs.  Y’s  neighbor,  who  was  not  a  tee¬ 
totaler,  had  been  so  kind  to  Mrs.  Y  during  her  children’s  sickness 
that  Mrs.  Y  could  not  refuse  her  the  small  favor  of  taking  in  her 
kettle  of  beer.  The  analogy,  therefore,  would  prove  a  mistaken 
one.  The  two  cases  would  have  had  only  a  superficial  similarity 
as  to  the  points  under  consideration.  This  is  the  danger  in  reason¬ 
ing  by  analogy,  and  is  one  into  which  we  all  of  us  fall.  We 
know  the  frequency  with  which  relief  officers  reason  that  since 

1  See  face  card  on  p.  84. 

91 


SOCIAL  DIAGNOSIS 


salt  cod  and  beans  are  acceptable  diet  for  family  A,  they  must 
be  equally  so  for  family  B.  The  first  family  may  be  composed  of 
a  sturdy  mother  with  big  husky  boys,  while  the  second  may  be  a 
tuberculous  woman  with  tiny  children.  Both  are  widows  with 
children,  and  beyond  that  the  analogy  does  not  hold. 

Our  tendency  to  assume  more  similarity  than  exists  between  the 
circumstances  of  an  old  case  and  of  a  new  one,  and  hence  apply 
our  experience  with  the  one  to  the  other,  often  checks  the  acquisi¬ 
tion  of  new  knowledge.  This  tendency  may  be  neutralized  in  the 
discussions  of  any  representative  case  committee — one  made  up, 
let  us  say,  of  a  few  professional  and  business  men,  of  several  house¬ 
wives,  a  neighborhood  tradesman,  a  nurse,  a  trade  unionist,  and 
of  some  of  the  social  workers  in  the  various  special  agencies.  Unless 
an  opinion  is  imposed  upon  all  by  someone  whom  they  respect  as 
an  authority,  each  one  present  will  at  once  draw  inferences  from  the 
outline  of  the  case  presented.  A  large  majority  of  these  inferences 
will  have  been  shaped  by  analogy  with  the  different  experiences  of 
these  people  of  varying  occupations  and  background.  Where  dis¬ 
cussion  is  free,  the  diversities  of  view  tend  to  offset  each  other  and 
to  bring  out  facts  showing  which  analogy  holds  good  and  which  is 
unwarranted. 

4.  Mistaken  Causal  Relation.  One  fact  shown  on  the  face 
card  given  on  p.  84  is  that  Mrs.  Ames'  mother  lives  with  her, 
although  Mr.  Ames  is  ill  and  the  family  in  need  of  aid.  Suppose 
one  infers  as  the  cause  of  this  situation  that  the  old  lady  has  less 
pleasant  relations  with  her  other  daughters  and  their  husbands 
than  with  the  Ameses.  Would  this  cause  operate  by  itself  or  would 
it  be  likely  to  act  along  with  other  causes  to  produce  the  given 
effect?  The  common  inclination  is  to  seek  for  one  cause.  Social 
workers,  however,  need  to  bear  in  mind  that  where  cause  must  be 
sought  in  human  motives,  as  is  apt  to  be  the  case  in  their  work, 
they  must  expect  to  find  not  that  it  is  a  single  simple  cause,  but 
that  it  is  complex  and  multiple.  In  the  case  of  Mrs.  Ames'  mother, 
should  it  turn  out  that  the  cause  after  all  was  simple,  the  social 
worker  can  test  first  the  adequacy  of  this  alleged  causal  relation. 
Having  accepted  the  mother's  liking  for  Mrs.  Ames  as  adequate 
cause,  the  worker  must  now  ask  whether  the  operation  of  this 
cause  is  thwarted  by  any  circumstance.  The  mother  may  prefer 

92 


INFERENCES 


/ 


Mrs.  Ames’  companionship  only  when  she  has  her  to  herself.  When 
the  husband  is  at  home,  jealousy  or  lack  of  sympathy  with  him 
may  seriously  mar  her  pleasure.  In  this  case  the  preference  for 
Mrs.  Ames,  although  in  itself  an  adequate  cause,  would  be 
thwarted  in  its  action.  Whether  this  is  the  case  or  not  the  worker 
must  apply  the  third  test  of  causal  relations  and  inquire  whether 
there  may  be  some  other  cause  for  the  mother’s  living  with  the 
Ameses.  The  next  alleged  cause  the  worker  must  examine  by  the 
same  method  as  this. 

Again,  we  see  on  the  face  card  that  Ames  worked  at  canvassing 
for  only  a  month,  when  he  returned  to  his  old  employer  as  door¬ 
man.  What  can  we  infer  as  a  reason?  Either  he  was  not  efficient 
at  the  canvassing  or  was  not  physically  equal  to  it  or  he  preferred 
a  steady  job  with  definite  wage  in  a  place  he  knew.  Any  one  of 
these  causes  would  have  been  adequate,  none  of  them  is  thwarted 
by  any  other  cause,  but  all  three  are  equally  possible.  We  can 
therefore  make  but  a  tentative  inference. 

The  facts  that  the  first  work  Ames  sought  after  leaving  the 
tuberculosis  sanatorium  was  canvassing,  and  that  this  was  not  his 
usual  occupation,  suggest  that  he  had  received  medical  advice  to 
get  outdoor  work.  This  inference  answers  all  three  tests.  While 
this  may  not  be  the  only  conceivable  reason  for  his  doing  this 
work,  it  is  certainly  the  most  probable  one.  In  reasoning  on  peo¬ 
ple’s  behavior,  one  would  seldom  arrive  at  more  than  a  strong 
probability  of  truth. 

Mrs.  F,  a  mother  of  growing  girls,  insists  on  keeping  a  man 
lodger  and  living  in  a  wretched  tenement  over  a  saloon,  in  spite 
of  generous  offers  from  relatives  of  better  living  conditions.  Shall 
we  infer  lax  standards  of  living?  This  cause  is  adequate,  it  is 
thwarted  by  no  other  circumstance,  but  is  it  the  only  possible 
cause  of  her  apparent  stubbornness?  She  says  herself  that  the 
objectionable  tenement  is  near  the  children’s  school  and  that  the 
landlord  has  been  good  to  her.  It  is  also  conceivable  that  she  is 
not  eager  to  move  near  her  relatives.  Our  inference,  therefore,  as 
to  her  standards  is  not  justified  except  as  a  hypothesis  to  be  con¬ 
firmed  by  more  evidence. 


93 


SOCIAL  DIAGNOSIS 


IV.  THE  RISKS  ARISING  FROM  THE  THINKER’S  STATE  OF  MIND 

1.  Predispositions.  Besides  the  risks  involved  in  thinking  as 
such,  there  are  risks  arising  from  the  thinker’s  state  of  mind.  The 
social  worker,  like  all  others,  has  certain  personal  and  professional 
predispositions  against  which  he  needs  to  be  on  guard.  What  do 
we  mean  by  predispositions?  For  our  present  purpose  we  may 
stretch  the  application  of  the  word  somewhat  to  include  the  sum 
of  all  those  personal  and  professional  habits  of  thinking  and  all 
those  feelings  and  inclinations  with  which  we  approach  each  new 
problem.  Our  predispositions  are  both  equipment  and  handicap. 
They  are  an  equipment  in  that  they  are  essential  to  individuality; 
they  are  a  handicap  in  that  they  limit  knowledge  in  one  direction 
or  another.  For  instance,  when  social  case  work  agencies  first 
became  aware  that  their  records  showed  a  confusion  between  fact 
and  opinion,  they  tried  to  meet  the  difficulty  by  instructing  their 
workers  to  omit  impressions,  opinions,  and  inferences  of  their  own, 
and  to  enter  upon  case  records  “  nothing  but  the  facts,”  reporting 
each  of  these  colorlessly,  “  as  it  happened.”  Workers  who  attempted 
to  follow  this  rule  produced  records  which  have  been  likened  to 
unstrung  beads;  in  the  attempt  to  eliminate  all  prejudice,  they 
eliminated  the  judgment  and  discernment  which  would  have  given 
to  the  whole  investigation  unity  and  significance.1 

Predispositions  may  obscure  for  us  the  significance  of  one  set 
of  facts  by  leading  us  to  exaggerate  the  importance  of  another  set, 
while  at  the  same  time  they  are  so  much  a  part  of  us  that  we  may 
easily  be  unaware  of  their  existence  and  consequently  of  their 
danger.  Such  an  effort  to  disregard  the  fact  of  our  having  predis¬ 
positions  as  that  shown  by  the  case  work  agencies  who  wanted 
“ nothing  but  the  facts”  from  their  visitors  is  likely  to  hamper 
investigation  by  deceiving  the  mind  into  a  belief  in  its  own  impar¬ 
tiality.  It  is  the  worker’s  very  awareness  of  his  special  predis¬ 
position  on  which  depends  the  reliability  of  his  observation  and 
judgment.  Once  he  brings  a  prejudice  into  the  light  of  day,  he 
can  offset  its  influence  on  his  thinking. 

1  A  critic  of  these  pages,  who  has  examined  many  case  records  of  late  in  many 
different  parts  of  the  United  States,  adds:  “Not  only  ‘unstrung  beads’  but  all 
about  the  same  size.  Wherever  the  ‘only  the  facts’  rule  applies,  the  tendency  is  for 
every  fact,  big  and  little,  to  occupy  about  the  same  space  in  the  record.  Everything 
is  brought  to  a  dead  level.” 


94 


,  INFERENCES 


2.  Assumptions.  As  professional  workers  become  experienced 
they  are  apt  to  gather  a  set  of  salted-down  rules,  or  more  correctly 
assumptions,  which  they  thereafter  apply  as  needing  no  further 
proof.  Some  of  these  assumptions  are  warranted,  others  are  not. 
In  dealing  with  cripples,  for  example,  social  workers  may  adopt 
unhesitatingly  the  assumption  that  physical  handicap  is  the  cause  of 
unemployment.  Closer  acquaintance  with  cripples  would  show 
that  many  do  well  in  employment,  and  that  of  those  who  do  not, 
some  fail  through  temperament,  some  through  the  limitations  of 
their  earlier  industrial  experience,  and  some  through  one  or 
another  physical  cause  unrelated  to  the  handicap  in  question.  In 
fact,  the  common  assumption  that  the  cripple’s  industrial  diffi¬ 
culties  are  insurmountable  is  his  most  serious  handicap. 

Again,  there  is  an  assumption  among  not  a  few  workers  that 
laziness  is  within  a  man’s  control,  whereas,  while  we  may  not  be 
able  to  say  it  is  never  so,  we  know  that  it  often  is  not. 

A  few  years  ago  it  was  assumed  among  social  workers  in  some 
communities  that  a  girl  with  a  second  illegitimate  child  was  hope¬ 
lessly  degraded  and  that  therefore  no  private  agency  should  at¬ 
tempt  to  cope  with  the  problem;  public  authorities  should  give  the 
necessary  care.  Indeed  this  feeling  was  so  strong  that  private 
rescue  homes  receiving  these  girls  were  thereby  somewhat  dis¬ 
credited.  Today  courageous  intensive  endeavor  has  shown  that 
some  of  the  most  successful  work  of  reconstruction  can  be  done 
with  the  unmarried  mother  of  two  children. 

The  reason  assumptions  such  as  these  persist  is  that  they  are 
not  examined;  they  are  taken  on  faith.  If,  however,  a  worker 
knows  his  assumption  to  be  what  it  is — unproven — he  may  ven¬ 
ture  to  act  upon  it.  He  may  know,  for  instance,  that  a  given 
man’s  laziness  may  conceivably  be  a  manifestation  of  disease,  yet, 
barring  any  other  indication  of  illness,  he  may  think  best  to  assume 
the  fellow’s  culpability  and  push  him  to  get  work. 

In  any  profession  one  acquires  certain  predispositions,  or  habits 
of  thought,  from  the  conditions  of  one’s  allotted  task  and  particular 
occupational  environment.  A  worker  in  a  child-helping  or  a  family 
rehabilitation  agency  in  a  large  American  city,  working  among 
recently  arrived  foreigners  who  have  become  dependent,  may  re¬ 
gard  immigration  as  a  menace,  unless  his  own  racial  prejudices 

95 


SOCIAL  DIAGNOSIS 


happen  to  offset  this  idea.  The  child-placing  agent  sometimes 
assumes  that  a  family  home  is  the  best  place  for  every  child,  and 
the  institution  worker  may  lean  too  far  the  other  way.  The  charity 
organization  worker  easily  takes  economic  independence  and 
family  solidarity  as  being  invariably  the  first  considerations,  while 
the  health  worker  readily  slights  both.  Each  specialist,  therefore, 
should  ask  himself  to  what  particular  overemphasis  he  is  rendered 
liable  by  the  nature  of  his  task,  and  at  that  particular  point  he 
should  be  at  especial  pains  to  collect  with  impartiality  the  evidence 
on  which  he  bases  decisions. 

3.  Some  Other  Habits  of  Thought.  There  are,  besides  untested 
assumptions,  other  habits  of  thought  that  case  workers  of  any  kind 
are  liable  to  fall  into.  yWe  found  that,  until  our  case  reading 
revealed  the  fact,  some  workers  were  unaware  that  they  consulted 
the  same  favorite  sources  of  information  habitually,  to  the  exclu¬ 
sion  of  other  sources  equally  good  or  better,  or  that  they  co¬ 
operated  heartily  with  only  a  certain  few  agencies — usually  with 
those  most  accessible.  Such  methods  mean  a  narrowed  resource¬ 
fulness,  with  a  few  favorite  remedies  applied,  a  few  combinations 
of  stops  pulled  out,  no  matter  what  the  demands  of  the  situation 
or  the  resources  available.  Moreover,  in  changing  from  one  city 
to  another  or  from  one  field  of  social  work  to  another,  a  worker 
must  guard  against  holding  fast  to  habits  which  may  have  been 
time-saving  originally  but  which  are  useless  under  changed  con¬ 
ditions.1  If  a  municipality’s  department  of  health  or  of  correction 
has  been  unco-operative,  one  who  faces  a  new  administration  or 
who  leaves  that  community  for  another  must  be  ready  to  drop 
the  habit  of  doing  without  this  help  from  public  officials  and  must 
welcome  a  changed  situation. 

Again,  the  trend  of  modern  social  ideals  often  confirms  in  the 
more  sophisticated  case  worker  a  habit  of  thinking  in  averages. 
Sometimes  a  case  worker  tends  to  become  overabsorbed  in  the 
individual  case,  but  a  commoner  failing  of  the  modern  type  of 

x“When  at  shearings  or  markings  they  run  the  yearlings  through  a  gate*For 
counting,  the  rate  of  going  accelerates  until  the  sheep  pass  too  rapidly  for  numbering. 
Then  the  shepherd  thrusts  his  staff  across  the  opening,  forcing  the  next  sheep  to 
jump,  and  the  next,  and  the  next,  until,  Jump!  says  the  flock-mind.  Then  he  with¬ 
draws  the  staff,  and  the  sheep  go  on  jumping  until  the  impulse  dies  as  the  dying 
peal  of  the  bells.”  Austin,  Mary:  The  Flock,  p.  1 14.  Boston,  Houghton,  Mifflin, 
and  Co.,  1906. 


INFERENCES 


worker  is  that,  oppressed  by  the  condition  of  the  mass,  he  misses 
a  clear  conception  of  the  one  client's  needs.  He  thinks  of  him  as 
one  of  a  class.  No  client  will  meet  with  successful  social  treatment 
if  so  regarded,  because  it  is  usually  his  particular  situation  and  not 
that  part  of  his  circumstances  which  he  shares  with  others  that  is 
the  immediate  point  at  issue.  Sidgwick  has  this  general  truth  in 
mind  when  he  says,  “In  forming  a  careful  conclusion  about  a 
particular  case,  no  one  with  any  sense  will  use  the  method  of  proba¬ 
bilities  if  he  has  an  opportunity  of  getting  behind  it  and  under¬ 
standing  the  causes  at  work  in  the  special  case."1  Sidgwick  means 
by  his  warning  about  the  “method  of  probabilities"  that,  though 
a  certain  manifestation  may  have  been  proved  statistically  to  have 
one  significance  in  ninety-seven  instances  out  of  a  hundred,  and 
a  quite  different  significance  in  the  three  others,  this  ratio,  useful 
for  action  affecting  a  hundred  in  the  mass,  has  a  different  sort  of 
value  in  dealing  with  a  single  case  about  which  more  intimate 
knowledge  is  available.  The  value  of  such  a  ratio  for  the  single 
case  is  that  it  necessarily  gives  rise  to  a  hypothesis  that  the  case 
in  question  is  one  of  the  ninety-seven.  This  hypothesis  is  useful 
in  that  it  guides  the  inquiry  which  may  or  may  not  show  the  single 
case  to  be  one  of  the  majority.  An  assumption  to  this  effect,  how¬ 
ever,  where  more  knowledge  is  available  about  a  particular  case, 
the  ratio  does  not  justify.  Were  the  case  worker  himself  one  of 
the  three,  would  he  care  to  be  treated  by  a  social  practitioner 
whose  habit  it  was  to  assume  his  client  to  be  one  of  the  ninety- 
seven?  At  the  same  time  it  would  hardly  be  an  intelligent  prac¬ 
titioner  who  did  not  under  these  circumstances  look  upon  it  before¬ 
hand  as  probable  that  the  client  would  turn  out  to  be  one  of  the 
ninety-seven. 

There  is  always  a  risk  that  one’s  personal  likes  and  dislikes  may 
influence  judgment.  Take,  for  example,  the  prejudices  and  special 
tendencies  that  belong  to  the  various  racial  and  social  groupings. 
Even  those  comparatively  rare  persons  whose  knowledge  of  the 
characteristics  of  many  different  social  groupings  of  people  is  broad 
enough  to  have  overcome  mere  class  prejudice  in  themselves  still 
belong  to  a  certain  habit-group  and  are  attracted  or  repelled  by 
like  or  unlike  customs  and  manners  in  others.  People  of  narrower 

1  The  Application  of  Logic,  p.  69. 

97 


7 


SOCIAL  DIAGNOSIS 


opportunity  are  almost  without  exception  warped  in  their  judg¬ 
ment  by  one  class  or  racial  prejudice  or  another,  while  at  the  same 
time  they  assume  that  social  bias  exists  only  in  the  other  fellow. 
As  such  personal  predispositions,  when  allowed  swing,  hinder  his 
work,  the  social  case  worker  needs  to  learn  to  set  them  aside. 

Besides  the  risk  in  drawing  inferences  which  arises  from  personal 
and  professional  predispositions,  there  is  a  risk  that  springs  from 
the  thinker's  own  desire  in  the  particular  instance,  (i)  to  see  his 
hypothesis  confirmed,  and  (2)  to  secure  prompt  action.  Such  a 
hypothesis,  for  instance,  as  that  about  the  Irishman  with  the  prison 
record1  becomes,  because  of  its  very  ingenuity,  the  favorite  child 
of  our  brain.  In  this  case,  it  is  true,  the  worker  sought  corrobo¬ 
rating  evidence.  Nevertheless,  the  danger  that  commonly  besets 
case  workers  is  that  of  becoming  so  fond  of  some  particular  hypoth¬ 
esis  that  it  will  seem  in  no  need  of  proof.  This  tendency  may 
have  especially  serious  consequences  in  the  case  of  a  first  hypoth¬ 
esis  that  we  have  to  make  in  a  more  or  less  obscure  case  in  order 
to  get  started.  The  whole  diagnosis  may  be  vitiated  by  an  un¬ 
warranted  assumption  at  the  beginning. 

^  The  worker’s  own  desire  to  secure  prompt  action  in  a  particular 
instance  is  also  often  responsible  for  invalid  inference.  In  the  case 
cited  on  p.  350,  Chapter  XVI 1 1,  in  spite  of  contradictions  in  the  evi¬ 
dence,  the  worker  in  his  hurry  to  get  an  answer  to  the  district  attorney 
drew  inferences  in  favor  of  the  wife;  whereas,  had  he  stopped  to 
test  these  inferences,  he  would  have  been  led  to  get  at  once  the 
additional  facts  that  showed  the  husband  to  be  the  better  of  the 
two. 

If  we  may  count,  as  two  essentials  of  the  social  diagnostician’s 
equipment,  his  ability  to  weigh  the  risks  involved  in  the  types  of 
evidence  described  in  the  chapter  on  Definitions,  and  his  ability  to 
measure  and  allow  for  the  characteristics  of  human  beings  as  wit¬ 
nesses — a  topic  which  has  also  received  attention — there  is  still 
the  third  essential;  namely,  the  ability  to  discriminate  between 
fact  and  inference  and,  through  inference,  to  deduce  new  facts. 
Then,  when  the  items  of  evidence  in  a  case  seem  to  be  at  hand, 
there  comes  a  time  for  considering  them  as  a  whole.  The  same 
reasoning  and  testing  that  has  been  applied  to  its  separate  items 

1  See  p.  86  of  this  chapter. 

98 


INFERENCES 


must  be  applied  deliberately  to  the  evidential  mass, 
t  •  n  to  this  later  in  Chapter  XVIII,  in  considering  the  co 
par  on  of  part  with  part,  as  well  as  the  final  act  of  interpretation, 
the  act  of  social  diagnosis  itself. 

When  we  face  each  situation  of  our  work  with  a  mind  alert 
receive  and  follow  suggestions,  alert  to  utilize  experience,  and  to 
make,  try,  and  test  one  hypothesis  after  another;  when  we  start 
out  with  entire  willingness  to  prove  or  disprove  our  every  inference, 
then  the  well  tested  inference  reveals  new  fact,  and  new  fact  sug¬ 
gests  new  inference  until  gradually  our  case  work  acquires  a  strong, 
closely  woven  texture  and  our  case  histories  become  documents 
that  will  well  repay  study.  It  is  upon  such  case  history  study, 
in  fact,  that  social  case  work  will  have  to  depend,  in  large  measure, 
for  advancing  standards  and  new  discovery.  Before  turning  to  the 
practical  details  to  which  so  large  a  part  of  the  remaining  chapters 
of  this  book  will  be  devoted,  it  should  be  said  with  emphasis  that 
there  can  be  no  good  case  work  without  clear  thinking;  that  in 
social  diagnosis  sound  reasoning  is  fundamental. 


SUMMARY  OF  THIS  CHAPTER 

1.  Inference  is  the  reasoning  process  by  which  we  pass  from  known  fact  to  fact 
that  is  unknown.  From  many  particular  cases  we  may  infer  a  general  truth,  or, 
as  happens  more  often  in  case  work,  from  a  general  truth  we  may  infer  some  new 
fact  about  a  particular  case. 

2.  A  first-stage  or  tentative  inference  is  called  a  hypothesis.  Resourcefulness 
in  making  and  patience  in  testing  hypotheses  are  fundamental  to  success  in  case 
work. 

3.  Corroboration  of  a  tentative  inference  may  have  to  be  gathered  deliberately 
or  it  may  lie  in  our  past  experience.  Past  experience  may  also  suggest  a  variety  of 
hypotheses — the  richer  the  experience  the  greater  the  variety,  and  the  greater  also 
the  likelihood  of  discovering  the  particular  one  which  will  prove  to  be  correct. 

4.  Gaps  in  evidence  may  make  it  necessary  to  seek  confirmation  of  a  hypothesis 
through  experiment,  though  the  conditions  of  controlled  experiment  are  achieved 
with  difficulty  in  social  work. 

5.  In  addition  to  the  risks  involved  in  testimony  which  may  be  incompetent  or 
biased,  there  are  risks  in  the  process  of  reasoning  from  testimony  even  when  it  is 
known  to  be  reliable,  including  risks  in  the  reasoner’s  own  state  of  mind. 

6.  The  risks  involved  in  the  reasoning  process  may  occur  in  four  ways:  we  may 
have  a  mistaken  general  rule,  a  mistaken  particular  case,  a  mistaken  analogy,  or  a 
mistaken  causal  relation. 


99 


SOCIAL  DIAGNOSIS 


^"7.  General  rules  that  apply  to  human  conduct  are  never  of  universal  application. 
Ofj£n  also  the  particular  case  assumed  to  come  under  a  given  general  rule  is  different 
from  what  it  is  supposed  to  be,  and  therefore  does  not  come  under  the  rule  in 
question. 

8.  Resemblances  between  two  cases  may  exist,  but  at  the  points  under  considera¬ 
tion  the  resemblance  may  be  only  superficial.  This  is  the  danger  in  reasoning  by 
analogy. 

9.  The  common  inclination  is  to  seek  for  one  cause  .  Where  cause  must  be  sought 
in  human  motives,  however,  we  must  expect  to  find  that  it  is  not  a  single  simple 
cause  but-oomplex  and  multiple. 

The  chief  risks  arising  from  the  case  worker’s  own  state  of  mind  are  found 
in  his  personal  and  professional  predispositions  and  in  his  assumptions — in  the 
salted-down  rules,  that  is,  which  are  the  product  of  his  experience. 

1 1.  The  best  safeguard  against  predispositions  is  to  be  aware  of  them.  Once  a 
personal  prejudice,  for  example,  is  brought  into  the  light  of  day,  its  influence  upon 
thinking  can  be  offset. 

12.  In  the  same  way,  if  a  worker  knows  his  assumption  to  be  what  it  is — un¬ 
proven — he  may  venture  to  act  upon  it  in  the  absence  (after  search)  of  evidence 
proving  it  to  be  unwarranted.  Unwarranted  case  work  assumptions  persist  because 
they  are  not  examined  and  are  taken  on  faith. 

13.  Other  ways  of  thinking  against  which  case  workers  may  be  warned  are  the 
habitual  use  of  a  few  favorite  sources  of  insight  or  co-operation,  the  continued  disuse 
under  changed  circumstances  of  a  source  which  was  formerly  not  available,  the 
habit  of  thinking  in  averages,  and  the  habit  of  regarding  with  especial  favor  a  first 
or  an  ingenious  hypothesis. 


PART  II 

THE  PROCESSES  LEADING  TO  DIAGNOSIS 


CHAPTER  VI 


THE  FIRST  INTERVIEW 


WE  TURN  now  to  the  details  of  social  case  work  method. 

It  will  be  necessary  to  remember  that  in  any  art 
the  description  of  its  processes  is  necessarily  far  more 
clumsy  than  are  the  processes  themselves.  In  the  last  analysis, 
moreover,  the  practitioner  of  an  art  must  discover  the  heart  of  the 
whole  matter  for  himself — it  is  of  the  essence  of  art  that  he  shall 
win  his  way  to  this  personal  revelation;  but  an  intimate  knowledge 
of  the  successes  and  failures,  the  experiences  and  points  of  view  of 
his  fellow  practitioners  will  be  found  to  be  essential  too.  The 
thirteen  chapters  that  follow  attempt  to  analyze  the  experiences 
of  case  workers  in  their  daily  use  of  the  four  processes  which  lead 
to  social  diagnosis. 

These  four  processes  are  (i)  the  first  full  interview  with  a  client, 
(2)  the  early  contacts  with  his  immediate  family,  (3)  the  search  for 
further  insight  and  for  sources  of  needed  co-operation  outside  his 
immediate  family,  (4)  the  careful  weighing  in  their  relation  to 
one  another  of  the  separate  items  of  evidence  thus  gathered  and 
their  interpretation.  By  interpretation  is  meant  the  attempt  to 
derive  from  all  the  evidence  as  exact  a  definition  as  possible  of  the 
client’s  social  difficulties — the  act  of  interpretation  is  the  act  of 
diagnosis. 

It  cannot  be  assumed  that  any  one  of  these  processes  is  always 
completed  before  another  begins.  When  the  First  Interview  is 
held  in  the  client’s  home,  contacts  with  the  family  often  overlap 
our  first  contact  with  the  client.  As  soon  as  we  have  two  state¬ 
ments  instead  of  one,  whether  these  come  from  the  family  or  from 
outside  sources,  we  begin  to  reason  about  them,  to  compare  them, 
and  to  draw  certain  tentative  inferences  from  them.  Nevertheless 
there  are  these  four  processes,  distinguishable  despite  their  inter- 
play. 


/ 


SOCIAL  DIAGNOSIS 


Many  social  workers  are  of  the  opinion  that  the  most  difficult 
and  important  is  the  first — the  initial  interview.  Probably  this  is 
the  part  of  the  diagnostician’s  task  in  which  personality,  as  con¬ 
trasted  with  technique,  counts  for  the  most,  for  here  he  should 
establish  some  basis  of  mutual  understanding  and  get  some  clues 
to  the  evidence  which  will  shape  his  judgment  later.  “  I  am 
more  and  more  convinced,”  wrote  the  secretary  of  a  large  family 
agency  years  ago  in  a  personal  letter,  “  that  the  finished  skill  of 
a  good  social  worker  is  mo-rt-'shpwn  in  this  first  visit  or  interview. 
No  knowledge  of  general  principles,  no  cleverness  in  gaining  co¬ 
operation,  no  virtues  in  the, worker,  and  no  committee,  however 
wise,  can  make  up  for  want  of  skill  in  gaining  quickly  the  Confidence 
of  the  family,  and  getting  the  foundation  for  all  good  work  to 
follow.”  Though  this  emphasis  is  usually  justified,  it  has  two 
i  possible  dangers:  It  may  discourage  us,  when  ground  has  been 
I  lost  in  the  First  Interview  or  not  gained,  from  pushing  forward 

/to  win  the  needed  understanding  later.  It  may  betray  us,  on  the 
other  hand,  into  resting  back  upon  the  outcome  of  an  apparently 
satisfactory  first  statement  and  failing  to  put  forth  our  best  en¬ 
deavors  in  the  further  necessary  steps. 

I.  MODIFYING  CIRCUMSTANCES 

Among  the  circumstances  which  must  modify  everything  said 
about  First  Interviews,  four  groups  are  important  enough  to  be 
kept  always  in  mind:  these  are  circumstances  relating  to  (i)  the 
nature  of  the  task,  (2)  the  origin  of  the  application,  (3)  the  place 
of  the  interview,  and  (4)  the  recorded  experience  available  as  a 
starting  point.  To  clear  the  ground  for  consideration  of  scope  and 
method  these  must  take  precedence. 

1.  The  Nature  of  the  Task.  The  form  of  service  to  be  under¬ 
taken  can  be  interpreted  narrowly  or  broadly,  of  course,  but  in 
either  case  a  number  of  variations  of  method  are  traceable  to  the 
nature  of  the  particular  case  worker’s  task.  If  an  agent  of  a 
society  to  protect  children  from  cruelty  knows  that  he  may  be 
cross-examined  by  the  lawyer  for  the  defense  as  to  what  took 
place  in  his  First  Interview  with  the  defendant,  inevitably  this 
will  modify  his  mode  of  approach,  for  he  must  be  able  to  testify, 
upon  occasion,  to  the  exact  form  of  his  questions.  Or  if,  to  take 

104 


THE  FIRST  INTERVIEW 


another  kind  of  service,  a  probation  officer  is  known  to  come  from 
the  court  and  to  represent  it,  certain  conditions,  favorable  and  the 
reverse,  are  created  by  this  fact;  the  officer  has  more  authority 
but  less  freedom  than  a  social  worker  who  lacks  the  court  back¬ 
ground.  He  often  finds  it  difficult  to  lead  the  minds  of  those 
directly  concerned  in  a  court  case  away  from  the  immediate  to  the 
wider  issues.1  A  worker  who  was  formerly  with  a  charity  organi¬ 
zation  society  and  then  became  the  agent  of  a  state  department  for 
the  care  of  children  found  it  much  harder  to  get  information  in  her 
second  capacity  than  in  her  first.  People  applied  to  her  for  a  per¬ 
fectly  definite  object,  namely,  to  have  their  children  taken  by  the 
public;  they  were  tremendously  on  their  guard  against  giving 
information  that  would  be  likely  to  interfere  with  that  object. 
On  the  other  hand,  the  agent  of  a  private  charity  known  to  control 
a  large  relief  fund  finds  his  interviews  hampered  by  this  fact  at 
every  turn.  The  immediate  material  benefit  looms  large;  the 
other  beneficent  functions  of  the  organization  and  the  steps  taken 
to  carry  them  out  are  little  understood  or  are  even  thrust  aside 
with  impatience.2 

The  hospital  and  the  school  furnish  admirable  means  of  approach 
for  social  work;  people  like  to  talk  about  their  ailments  and  about 
their  children.  Both  have  this  disadvantage,  however,  that  the 


XA  former  probation  officer  writes,  “Conversation  that  had  to  do  with  the 
offender  was  easy;  talk  that  would  go  deeper  into  the  family  situation  taxed  in¬ 
genuity  and  tact.” 

2  “On  my  first  movements  through  the  poorest  parish  in  Glasgow,  I  was  thronged 
by  urgencies  innumerable,  because  of  my  official  connexion  with  the  secular  charities 
of  the  place,  and  which  did  invest  me  with  the  character  of  an  almoner  in  the  eyes 
of  the  general  population.  .  .  .  What  I  judged  and  apprehended  as  the  conse¬ 

quence  of  this  was,  that  it  would  neutralise  the  influence  which  I  wanted  to  have 
as  a  Christian  minister.  I  saw  that  this  would  vitiate  my  influence  among  them. 
I  felt  that  it  would  never  do  if  I  were  to  go  among  them,  first  as  a  dispenser  of  tem¬ 
poral  good  things,  and  then  as  urging  upon  them  the  things  which  make  for  their 
everlasting  peace.  I  felt  the  want  of  compatibility  between  the  two  objects,  and, 
rather  than  defeat  my  primary  object,  1  determined  to  cut  my  connexion  with  the 
city  charities  .  .  .  and  I  will  not  forget  the  instant  effect  of  this  proceeding 

when  it  came  to  be  understood — the  complete  exemption  which  it  gave  me  from  the 
claims  and  competitions  of  a  whole  host  of  aspirants  who  crowded  around  me  for 
a  share  in  the  dispensations  of  some  one  or  other  benevolent  trust  or  endowment  of 
other  days;  and  yet  the  cordial  welcomes  I  continued  to  meet  with  when,  after  I 
had  shaken  loose  of  all  these,  I  was  received  and  recognised  by  the  people  on  the 
simple  footing  of  their  Christian  friend,  who  took  cognisance  of  their  souls,  and  gave 
himself  chiefly  to  do  with  the  scholarship  of  their  young,  and  the  religious  state  of 
their  sick,  and  their  aged  and  their  dying.” — Chalmers  on  Charity,  p.  154  sq. 

105 


< 


r 


SOCIAL  DIAGNOSIS 


task  which  is  easily  understood  and  easily  explained  tends  to  be¬ 
come  limited  in  scope — to  ignore  the  relation,  for  instance,  be¬ 
tween  health  questions  and  economic  questions,  between  questions 
of  child  welfare  and  those  of  family  responsibility.  Short  tasks 
of  any  kind  seem,  on  their  face,  to  make  thorough  diagnosis  an 
unnecessary  preliminary.  Much  of  our  social  work  is  so  cut  up 
and  subdivided  at  present  that  it  drifts  into  rapid-fire,  hit-or-miss 
forms  of  treatment.  If  the  nature  of  a  particular  form  of  service 
makes  a  careful  definition  of  the  client’s  social  difficulties  seem 
impertinent,  there  is  always  a  chance  that  the  details  of  its  program 
are  in  need  of  revision,  that  it  should  operate  in  a  smaller  territory 
or  attempt  to  benefit  fewer  people  and  really  cover  the  ground.1 

2.  The  Origin  of  the  Application,  (a)  The  client  comes  in 
person  to  the  social  agency  of  his  own  initiative;  (b)  or  with  a 
letter  of  reference  from  some  individual  or  organization,  or  with 
an  oral  statement  that  he  has  been  so  referred;  (c)  someone  acting 
in  his  individual  capacity  or  as  representative  of  an  organization 
comes  personally,  instead,  in  the  client’s  interest;  (d)  or  sends  his 
request  through"  the  ntail  or  by  telephone.  Thus  we  find  our  First 
Interview  modified  at  the  very  start  not  only  by  the  nature  of  our 
own  interest  but  by  the  way  in  which  it  is  evoked.  If  the  client  visits 
us,  whether  of  his  own  initiative  or  otherwise,  our  program  varies 
somewhat  from  that  following  a  request  to  visit  him.  If  individual 
citizens  or  organizations  in  some  way  concerned  for  his  welfare  make 
the  request,  we  have  one  advantage  in  that  a  possible  outside  source 
of  insight  and  co-operation  is  available  from  the  very  beginning. 

3.  The  Place  of  the  Interview.  The  place  in  which  the  First 
Interview  is  held  depends  in  part  upon  the  nature  of  the  task  and 
its  origin,  but  not  wholly  upon  these.  Societies  dealing  with  ques¬ 
tions  of  family  relief  and,  in  these  later  days,  with  family  rebuild¬ 
ing  have  changed  their  policy  several  times  with  regard  to  the  place 
of  the  interview.  Following  the  line  of  least  resistance,  the  older 
type  of  worker  usually  conducted  First  Interviews  at  his  office 
desk,  with  record  form  before  him  and  pen  in  hand.  He  asked 
each  question  in  the  order  indicated  by  the  items  on  the  form,  and 

1  Another  excuse  often  given  for  hasty  preliminary  inquiry  is  the  probability  that 
the  case  will  be  transferred  to  another  social  agency  for  treatment.  See  Chapter 
XVI,  Social  Agencies  as  Sources,  on  the  advisability  of  thorough  diagnosis  before 
transfer,  p.  313. 

106 


/ 

THE  FIRST  INTERVIEW 

filled  in  a  short  summary  of  the  perfunctory  reply  before  going  on 
to  the  next:  Assistance  asked?  “Coal  and  groceries/'  Cause 
of  need?  “Out  of  work."  Any  relatives  able  to  assist?  “No." 

As  a  reaction  against  this  stupid  compiling  of  misleading  items, 
many  American  case  workers  have  abandoned  the  office  inter¬ 
view,  except  in  emergencies  and  in  dealing  with  the  homeless. 
It  is  their  practice  to  take  only  time  enough,  when  application  is 
made  at  the  office,  to  assure  themselves  that  treatment  is  probably 
needed,  and  then  promptly  to  make  a  visit  to  the  home,  where,  in 
an  unhurried  talk,  the  basis  is  laid  for  further  acquaintance. 

The  arguments  in  favor  of  holding  the  First  Interview  in  the 
home  instead  of  in  the  office  are,  in  family  work,  (a)  Its  chal¬ 
lenge  to  the  case  worker  at  the  outset  to  establish  a  human  rela¬ 
tion,  at  the  risk,  if  he  fail,  of  coming  away  without  the  simplest 
and  most  elementary  data.  In  the  office,  clients  are  on  the  de¬ 
fensive  and  justify  their  visits  by  their  replies.  In  the  home, 
the  social  worker  is  on  the  defensive;  the  host  and  hostess  are  at 
their  ease,  (b)  Its  avoidance  of  the  need  of  so  many  questions, 
some  of  which  are  answered  unasked  by  the  communicative  hostess 
and  by  her  surroundings.  To  the  quiet  observer  the  photographs 
on  the  wall,  the  framed  certificates  of  membership  in  fraternal 
orders,  the  pensioner's  war  relics,  the  Sunday  school  books,  the 
household  arrangements  are  all  eloquent.  And  far  more  revealing 
than  these  material  items  are  the  apparent  relations  of  the  members 
of  the  household  to  one  another — the  whole  atmosphere  of  the 
home,  (c)  Its  provision  of  natural  openings  for  a  frank  exchange 
of  experiences.  “The  great  facts  of  birth  and  death  alone  are 
sufficient  to  make  the  whole  world  kin,"  and  these  and  the  uni¬ 
versally  interesting  comparison  of  diseases  form  a  good  basis  for 
that  kind  of  informal  intercourse  which  belongs  to  the  fireside. 
Then,  if  some  of  the  children  are  present  for  a  part  of  the  time  at 
least,  there  is  a  good  chance  for  comparing  notes  about  brothers 
and  sisters,  their  ages,  names,  namesakes,  etc.1  (d)  Its  further 
emphasis  upon  the  personal  side  when  there  has  been  no  visit  by 
the  client  to  an  office,  but  when  his  situation  has  been  reported 
there  instead  by  others;  its  relegation  of  official  paraphernalia 
and  attitudes,  in  such;  instances  at  least,  to  the  rear. 

1  See  Miss  M.'  L.  Birtwell’s  pamphlet  on  Investigation. 

107 


SOCIAL  DIAGNOSIS 


A  few  years  ago  these  arguments  in  favor  of  the  home  interview 
would  have  been  regarded  as  inadequately  offset  by  the  counter¬ 
arguments  of  greater  convenience,  accuracy,  and  saving  of  time  in 
the  office  interview.  But  now  a  certain  number  of  social  workers, 
even  some  of  those  specializing  in  family  work,  are  beginning  to 
feel  that  there  is  much  to  be  said  in  favor  of  the  office  interview,  if 
properly  conducted.  They  assume  that  the  one  who  conducts  it 
will  later  visit  the  home,  that  there  will  be  no  lesion  at  this  im¬ 
portant  point  through  a  division  of  the  task  between  two  work¬ 
ers.  The  return  to  the  older  method  is  a  return  with  a  difference — 
a  return  with  office  equipment  which  assures  entire  and  uninter¬ 
rupted  privacy,  ample  time,  no  herding  of  waiting  clients,  and  no 
record  form  or  other  bit  of  officialism  in  the  foreground.1 

Inquiry  as  to  current  practice  in  other  forms  of  social  work  shows 
interesting  variations.  The  general  secretary  of  a  society  to  pro¬ 
tect  children  from  cruelty  feels  that  it  is  most  important  to  see 
the  home  environment  before  making  any  inquiries  outside.  The 
agent  of  a  public  department  for  dependent  children  finds  that 
clients  come  to  the  office  of  the  department  braced  and  tense. 
She  urges  that  only  a  clerk  see  them,  and  that  the  First  Interview 
be  held  in  their  own  surroundings.  On  the  other  hand,  a  charity 
organization  worker  tells  of  stolid'  Bohemian  housewives  who  pay 
little  attention  to  visitors  at  their  homes,  continuing  their  house¬ 
work  so  unconcernedly  during  an  entire  interview  that  it  is  im¬ 
possible  to  make  any  real  progress.  The  strongest  evidence  in 
favor  of  the  office  interview  comes  from  the  medical-social  group. 
One  of  these,  who  was  formerly  a  district  secretary  of  a  charity 
organization  society,  furnishes  the  following  memorandum: 

The  hospital  social  worker  always  has  a  good  straightforward  introduction  to 
the  patient  in  the  perfectly  definite  request  or  inquiry  made  by  the  doctor:  “In- 

1  “We  have  found,”  Mrs.  Chesley  of  the  Paine  Fund  writes  in  the  Survey  for 
May  22,  1909,  “that  the  best  place  to  obtain  this  knowledge  [of  the  client’s  point 
of  view]  has  been  in  the  privacy  and  seclusion  of  the  little  room  of  the  Parish  House 
which  the  committee  uses  for  an  office.  Of  course,  applicants  are  seen  in  their 
homes,  often  many  times,  but  people  are  much  more  self-conscious  in  their  homes, 
especially  if  we  go  as  strangers  and  our  visit  is  unexpected.  In  the  majority  of 
homes  we  are  never  free  from  interruptions  from  children  or  neighbors,  and  we  can 
never  be  quite  sure  that  there  is  not  someone  in  the  next  room  listening  to  all  we 
say.” 

The  statement  as  to  self-consciousness  may  be  open  to  question,  but  the  lack  of 
privacy  in  many  crowded  city  neighborhoods  is  undoubtedly  a  real  difficulty. 

108 


THE  FIRST  INTERVIEW 


struction  in  hygiene,”  “sanitarium  care,”  “light  work,”  “medicines  don’t  help, 
what  is  the  trouble  at  home?”  “help  in  buying  brace,  $9,”  etc.  The  patient  can 
almost  without  exception  see  the  connection  between  the  worker’s  questions  and 
this  definite  object.  Hence  he  is  not  suspicious  or  puzzled,  and  you  are  freed  from 
any  temptation  to  indirectness,  subterfuge,  concealment  or  ambiguity,  into  which 
you  might  drift  in  spite  of  yourself  while  striving  to  help  a  poor  person  referred  by 
somebody  “who  does  not  wish  his  name  used,”  or  who  thinks  the  poor  family  “so 
proud  and  sensitive  that  they  must  never  know  the  associated  charities  is  called  in,” 
or  by  that  wealthy  relative  who  would  like  to  help  but  “does  not  wish  the  poor 
cousins  to  know  where  the  money  comes  from.”  Such  situations  seem  to  me  to 
involve  positive  deception.  I  know  they  have  entangled  more  than  one  C.  O.  S. 
worker,  and  it  seems  to  me  that  a  definite  stand  should  be  taken  and  a  way  out 
found,  as  the  final  results  of  such  work  can  only  be  an  injury  to  all  concerned. 

In  the  hospital  no  such  situation  can  possibly  arise — you  can  proceed  by  the 
shortest  and  most  direct  route  to  the  matter  in  hand.  The  air  is  clear,  and  you  can 
look  your  patient  straight  in  the  eyes  and  say,  perhaps,  “The  doctor  naturally  can’t 
stop  to  discuss  with  you  how  you  are  going  to  get  this  expensive  brace,  but  if  you 
will  explain  to  me  just  how  you  are  situated,  we  will  talk  over  possible  plans.”  This 
leads  quite  naturally  to  a  businesslike  discussion  of  income  and  expenses  and  re¬ 
sources  of  all  kinds,  without  any  “fishing  for  facts.”  As  a  result,  (a)  the  first  inter¬ 
view  takes  place  at  the  hospital;  (b)  the  introduction  is  easy  and  the  approach  to 
the  immediate  problem  direct  and  businesslike;  (c)  extended  explanation  is  some¬ 
times  needed  to  make  the  patient  see  the  relation  of  the  interview  to  his  recovery — 
this  is  done  frankly  and  seldom  fails.  (I  recall  only  two  cases  of  failure  in  the  year 
and  a  half  I  have  been  at  the  hospital.)  (d)  The  co-operation  of  the  patient  in 
revealing  his  story  is  pretty  sure. 


Two  medical-social  workers  suggest  one  exception  in  favor  of 
the  home  interview.  Deaf  patients  often  come  to  the  social  ser¬ 
vice  department  from  the  clinical  examination  too  sick  and  tired 
to  stand  another  long  interview.  If  questioned  at  all,  they  must 
be  questioned  so  loudly  that  they  become  conscious  of  being  over¬ 
heard  and  are  too  embarrassed  by  this  to  talk  freely.  In  such  cases 
only  those  statements  are  taken  which  are  needed  to  identify  the 
patient  in  the  confidential  or  social  service  exchange,1  and  the 
First  Interview  is  held  in  the  home. 

Some  interviews  are  best  held  on  neutral  ground,  as  at  a  settle¬ 
ment  or  some  other  neighborhood  center.  A  children's  worker 
describes  a  painful  interview  with  a  domestic  who  had  applied  to 
have  her  child  boarded  out,  held  in  the  front  room  of  the  house 
in  which  she  was  at  service.  It  happened  to  be  a  doctor’s  office, 
and  she  was  so  fearful  of  the  return  of  the  doctor  that  it  was  im- 
1  For  description  see  Chapter  XVI,  Social  Agencies  as  Sources,  p.  303  sq. 

IO9 


SOCIAL  DIAGNOSIS 


possible  to  get  her  to  talk  freely.  The  interview  should  have  been 
postponed  to  some  other  time  and  place. 

It  would  seem,  to  sum  up,  that  wherever  the  sense  of  strangeness 
may  be  worn  away  most  quickly,  wherever  a  good  understanding 
with  our  client  may  be  established  most  easily,  is  the  right  place 
for  the  first  long  talk;  and  whether  this  place  be  the  home  or  the 
office  must  depend  upon  conditions  which  vary  with  locality,  with 
the  nature  of  the  work  to  be  undertaken,  and  with  the  tempera¬ 
ment  and  equipment  of  the  worker.  The  preoccupation  of  the 
client  with  the  immediate  crisis  is  one  of  the  things  to  be  avoided  in 
the  choice  of  a  place;  no  conditions  should  interfere  with  our  efforts 
to  lead  his  mind  back  to  the  events  that  will  reveal  the  deeper- 
seated  difficulties  of  his  life,  and  forward  to  the  possible  ways  out. 
In  so  far  as  the  home  and  its  familiar  objects  suggest  the  more 
normal  aspects  of  his  life,  they  are  a  great  help.  Some  places  in 
their  very  nature  emphasize  the  crisis — a  court  room  does,  or  the 
waiting  room  of  a  busy  relief  bureau.  This  emphasis  is  a  barrier 
between  case  worker  and  client. 

4.  The  Recorded  Experience  Available  as  a  Starting  Point. 
It  will  save  the  client's  time  and  assure  him  better  service  to  dis¬ 
cover  at  once  whether  he  has  ever  before  been  a  client  of  the  social 
agency  now  about  to  take  up  his  application.  For  a  dozen  reas¬ 
ons — the  fact  that  the  agency  has  offices  in  different  parts  of  the 
city,  has  removed  its  offices,  has  changed  its  workers,  or  is  one  of 
a  number  of  organizations  doing  similar  work — he  will  not  always 
be  able  to  answer  this  question  correctly;  sometimes  he  may  not 
wish  to  do  so;  but  data  enough  to  settle  whether  he  or  other 
members  of  his  immediate  family  are  already  known  should  be 
procured  before  the  full  interview  with  him  gets  under  way.  Action 
can  be  taken  more  promptly  and  intelligently  and  many  prelimi¬ 
naries  be  dispensed  with,  if  the  earlier  record,  should  there  be  one, 
is  consulted  without  a  moment's  delay. 

If  the  client  makes  his  application  in  person,  this  is  easily  done. 
At  the  very  beginning  of  talk  with  him,  first  names  of  his  immediate 
family,  ages  of  children,  present  address,  and  former  addresses  (if 
the  last  removal  was  recent)  can  be  had,  and  these  will  enable  a 
clerk  to  find  the  previous  record,  if  any,  in  the  office  files.  It 


THE  FIRST  INTERVIEW 


would  seem  unnecessary  to  mention  this,  if  some  social  agencies 
were  not  known  to  be  very  careless  in  the  matter. 

Wherever  a  confidential  or  social  service  exchange  has  been 
established  among  the  social  agencies  of  a  community,  the  clerk 
can  take  the  further  step,  at  the  same  time,  of  telephoning  to  the 
exchange.  In  the  absence  of  an  exchange,  other  social  agencies 
which  have  been  mentioned  by  the  client  or  which  are  likely  to  be 
interested  can  be  inquired  of,  but  the  service  that  an  exchange 
can  render,  as  developed  fully  in  a  later  chapter,  becomes  a  great 
protection  to  everyone  concerned,  most  of  all  to  the  client  him¬ 
self.1 

When  the  exchange  reports,  in  reply  to  inquiry,  that  certain 
other  agencies  which  it  names  have  also  inquired  about  the  client 
on  such  and  such  dates,  their  experience  should  be  had  before  our 
first  visit  to  his  home,  and  preferably  before  our  first  full  interview. 
The  details  of  these  consultations  are  also  described  under  the 
heading  of  the  Confidential  Exchange;  they  need  not  detain  us 
here,  except  to  add  that,  where  the  data  first  given  reveal  no  record 
and  fuller  data — names  of  relatives,  etc. — are  at  hand  a  little  later, 
after  the  fuller  interview,  there  should  be  a  second  inquiry  of  the 
exchange,  and  a  second  search,  of  course,  of  the  agency's  own  files. 

i'-r  .v  -r* 

II.  SCOPE 

It  might  be  said  that  the  circumstances  which  modify  a  First 
Interview  most  of  all  are  the  case  worker's  own  knowledge  of 
social  disabilities,  and  his  conception  of  the  possibilities  of  social 
treatment.  But  these  are  something  more  than  circumstance; 
they  are  the  medium,  the  surrounding  atmosphere  of  all  his  en¬ 
deavor.  His  attitude  toward  social  disabilities  and  their  treat¬ 
ment,  plus  his  native  instinct  for  the  facts  and  values  of  human 
nature,  are  an  important  part  of  his  social  philosophy.  Every  itemN^ 
in  the  processes  leading  to  diagnosis,  from  the  first  moment  of  the 
First  Interview,  through  the  unwinding  of  the  last  clue,  to  the  final 
step  of  defining  in  as  specific  terms  as  possible  the  client's  actual  social 
situation,  will  be  shaped  by  this  knowledge  and  by  this  philosophy 
or  will  be  marred  by  their  lack.  Formative  in  its  influence  also  is 

1  See  section,  the  Confidential  Exchange,  in  Chapter  XVI,  Social  Agencies  as 
Sources. 

I  I  I 


SOCIAL  DIAGNOSIS 


the  clear  determination  to  make  the  treatment  of  which  diagnosis 
is  only  a  first  step  helpful. 

Starting  with  these  assumptions,  what  should  be,  in  general, 
the  objects  and  scope  of  a  First  Interview? 

The  establishment  of  a  good  understanding  at  this  point  has 
seemed  to  some  workers  so  important  and  they  have  so  overrated 
its  difficulty  that  they  have  advocated  confining  the  First  Inter¬ 
view  to  expressions  of  friendly  interest  and  sympathy,  in  the  hope 
that  the  clues  upon  which  outside  inquiries  depend  may  be  gradually 
elicited  later.  But  dodging  the  difficulty  makes  more  difficulty. 
If  a  good  understanding  were  our  goal,  this  might  be  the  way  in 
which  to  begin;  but  our  purpose  is  to  get  something  done,  and 
usually  the  saving  of  time  is  a  most  important  part  of  getting  that 
something  effectively  accomplished.  The  social  jdiagnosis  that  is 
not  made  with  a  reasonable  degree  of  promptness  may  be  made  too 
late.  This  view  is  emphasized  by  a  case  worker  of  long  experience 
in  a  letter  written  to  one  of  comparatively  short  experience,  who, 
working  in  a  family  agency,  advocated  delay  because  clients  so 
often  in  their  first  contacts  with  him  seemed  to  have  “framed  up” 
their  story.  The  adviser  wrote: 

Is  not  the  made-up  story  you  hear  usually  focussed  upon  today’s  situation,  and 
is  not  a  part  of  it  really  true?  There  are  a  few  deliberate  frauds  who  are  clever 
enough  to  make  up  a  long  tale  and  have  it  hang  together,  but  most  people,  well-to-do 
or  poor,  are  not  quick-witted  enough  for  this.  A  kindly  listener  who  hears  what  the 
applicant  has  made  up  his  mind  to  say,  and  sympathetically  draws  him  on  to  talk 
of  other  things,  getting  a  story  which  runs  back  through  all  his  life  and  looks  forward 
to  the  future,  has  got  something  of  which  the  made-up  story  forms  a  very  small  part. 
If  the  mind  of  the  person  in  distress  is  all  on  the  present,  one  may  say,  “Well, 
suppose  I  am  able  to  arrange  just  what  you  ask,  what  about  next  week  or  month  or 
year?”  One  secretary  likes,  when  she  can,  to  say  to  a  man,  “Now  suppose  you 
could  arrange  life  just  as  you  wanted  it,  what  work  would  you  really  like  to  be 
doing?’’ — thus  getting  at  a  man’s  ideals  and  encouraging  him  by  letting  his  mind 
dwell  on  them  for  a  moment.  Sometimes  she  is  able  to  turn  things  that  way  or 
to  some  task  more  congenial  than  the  old  one.  That  for  the  future.  As  to  the  past, 
one  of  my  friends  has  learned  that  the  question  addressed  to  a  husband  or  wife  of 
“How  did  you  two  happen  to  get  acquainted?”  will  often  lighten  present  distress 
by  a  memory  of  happier  times,  and  also  bring  a  flood  of  information  as  to  the  rela¬ 
tives  on  both  sides,  former  home  and  occupation,  the  standard  of  living  to  which 
they  were  then  accustomed,  and  so  on. 

From  points  which  do  not  seem  to  them  essential,  and  would  not  to  the  investi¬ 
gator  but  that  earlier  omissions  have  proved  them  so,  one  gets  clues  not  only  to 

I  12 


THE  FIRST  INTERVIEW 


possible  inquiry  from  others,  but  to  the  character  and  psychology  of  the  family 
itself.  Afterward  what  proves  to  be  untrue  may  be  ignored,  and  between  the  family 
and  the  investigator  a  common  knowledge  of  what  is  true  may  be  taken  for 
granted. 

Are  you  quite  sure  that  your  own  attitude — the  feeling  that  what  the  applicant 
is  going  to  tell  you  when  he  first  appears  “is  a  story  well  framed  up” — one  that  will 
“not  hold  good  upon  investigation” — is  as  free  from  the  suspicion  that  you  depre¬ 
cate  as  is  the  method  I  advocate?  Guiding  the  conversation  does  not  mean  ques¬ 
tioning,  necessarily.  .  .  . 

You  remember  I  pointed  out  in  the  M - record  that  you  had  to  go  twice  to 

the  hospital  and  doctor  because  you  had  not  got  in  the  first  interview  with  either 
of  them  all  they  were  willing  to  tell.  The  same  waste  of  time  and  energy  is  avoided 
by  a  full  first  interview  with  the  family,  and  it  is  sometimes  not  so  easy  to  get  in¬ 
formation  in  the  second  interview  with  a  family — they  believing  that  they  have  told 
before  all  that  is  necessary — as  it  is  from  a  hospital  or  a  doctor  to  whom  one  can 
more  easily  explain. 

As  to  the  family’s  attitude,  it  is  often  like  that  of  a  patient  who  for  the  first 
time  finds  a  doctor  who  really  gets  to  the  bottom  of  his  trouble,  taking  in  not  merely 
obvious  present  symptoms  but  showing  unexpected  insight  into  matters  of  whose 
relation  to  the  trouble  the  patient  has  been  unconscious.  The  patient  goes  away 
with  new  hope  and  fresh  resolves  to  do  his  full  part.  Of  course,  not  everything  is 
gained  in  one  interview.  That  is  to  be  supplemented  by  outside  inquiries,  and  when 
one  can  arrange  for  continued  personal  relationships,  by  the  gradual  unfolding  that 
comes  in  these.  Sometimes  later  interviews  prove  of  equal  value.  But  without 
exception  in  my  experience,  investigators  who  have  taken  your  view  as  to  the  first 
interview  have  been  the  least  successful  in  the  average  outcome  as  to  their  families. 


Here,  then,  we  have  the  attitude:  a  cheerful  willingness  to  listen 
to  the  present  symptoms  which  seem  so  important  to  the  one  inter¬ 
viewed,  but  a  quiet  determination  to  get  below  this  to  a  broader 
basis  of  knowledge,  by  carrying  the  client's  mind  forward  to  hopes 
and  possibilities  ahead,  and  backward  to  the  happier,  more  normal 
relations  of  the  past.1  And  since,  if  we  would  help  him,  we  must 
break  through  the  narrow  circle  of  our  client's  own  view  and  get 
into  the  wider  one  of  those  who  know  and  understand  him,  we  must 
depend  upon  the  First  Interview  for  those  clues  which  are  most 
likely  to  supplement  and  round  out  his  story.  “  I  never  mean  to 
leave  a  family,"  says  a  case  worker  of  long  experience,  “until  I 
have  some  clue  or  other  for  obtaining  outside  information,  no 
matter  how  long  it  takes  me  to  get  it." 

1  Emergency  interviews  may  seem  to  present  an  exception  to  this  general  state¬ 
ment.  They  are  discussed  later,  p.  13 1. 

8  I  13 


SOCIAL  DIAGNOSIS 


It  would  appear,  then,  that  the  objects  of  a  First  Interview  are 
fourfold: 

1.  To  give  the  client  a  fair  and  patient  hearing. 

2.  To  establish,  if  possible,  a  sympathetic  mutual  understand¬ 
ing — a  good  basis,  that  is,  for  further  intercourse. 

3.  To  secure  clues  to  whatever  other  sources  of  information  will 
give  a  deeper  insight  into  the  difficulties  of  his  situation  and  their 
possible  solutions. 

4.  To  begin  even  at  this  early  stage  the  slow  process  of  develop¬ 
ing  self-help  and  self-reliance,  though  only  by  the  tonic  influence 
which  an  understanding  spirit  always  exerts,  and  with  the  realiza¬ 
tion  that  later  the  client's  own  level  of  endeavor  will  have  to  be 
sought,  found,  and  respected.1 

These  apparently  separate  and  sometimes  apparently  conflict¬ 
ing  tasks  are  four  parts  of  one  purpose.  We  wish  to  serve,  and  we 
desire  to  influence  in  order  to  serve,  but  influence  exerted  in  a  mis¬ 
taken  direction  would  be  worse  than  futile;  we  wish  to  serve,  and  we 
desire  to  know  in  order  to  serve,  but  knowledge  is  an  impotent 
thing  in  the  hands  of  one  who  has  lost,  through  impatience,  the  chance 
to  use  it.  Consideration  of  this  aspect  emphasizes  the  difficulty. 
The  way  out  of  the  difficulty  is  to  see  clearly  that  frank  and  in¬ 
formal  talk  can  be  a  help  both  in  winning  a  common  understanding 
and  in  securing  clues  to  the  coadjutors  who  can  help  us  to  understand 
still  better.  How  soon  the  ground  already  won  can  be  lost  with¬ 
out  their  co-operation  any  candid  examination  of  social  case  rec¬ 
ords  would  prove  only  too  conclusively.  Social  work  is  team  work. 
It  must  be  conceded  that  good  will  and  patience  will  not  always 
bring  the  needed  data;  it  is  possible  to  waste  time  by  pushing 
stubbornly  and  immediately  for  every  available  clue.  In  a  small 
minority  of  interviews,  it  is  better  to  trust  to  finding  more  clues 
outside  in  the  course  of  following  up  the  few  that  are  grudgingly 

1  "The  study  of  defectives  and  failures  brings  home  to  us  most  forcibly  a  funda¬ 
mental  fact  of  economics, — that  certain  persons  are  adequately  endowed  for  small 
demands,  but  are  bound  to  fail  under  an  excessive  demand.  There  would  be  far 
more  happiness  and  real  success  in  mental  hygiene,  if  more  people  would  realize 
that  at  every  step,  every  person  can  do  something  well  and  take  a  satisfaction  in 
doing  it,  and  that  this  satisfaction  in  something  done  is  to  be  valued  as  ten  times 
greater  than  the  satisfaction  taken  in  mere  thought  or  imagination,  however  lofty.” 
— Adolf  Meyer:  What  Do  Histories  of  Cases  of  Insanity  Teach  Us  Concerning 
Preventive  Mental  Hygiene  During  the  Years  of  School  Life? 

1 14 


THE  FIRST  INTERVIEW 


revealed;  and,  with  a  still  smaller  remnant,  treatment  has  to  be¬ 
gin  in  an  experimental  way  before  any  evidence  can  be  brought 
to  light  upon  which  a  plan  of  treatment  can  be  solidly  based. 


III.  METHOD 


1.  The  Approach.  As  often  happens,  the  best  description  of 


method  comes  to  us  from  practitioners  in  other  fields.  Dr.  Adolf 


Meyer  in  an  unpublished  document  instructs  the  psychiatrists 
who  are  his  students  as  follows: 

j  For  any  examination,  the  mode  of  approach  is  absolutely  decisive  of  the  result. 
The  reserve  of  the  patient  is  usually  a  factor  to  be  reckoned  with,  or,  if  not  the  re¬ 
serve,  at  least  the  unwillingness  to  show  a  clear  picture  of  decidedly  peculiar  ex¬ 
periences.  It  is,  therefore,  necessary  to  gain  the  confidence  by  treating  the  patient 
"as  a  sensible  man  or  woman,”  and,  wherever  the  patient  does  not  speak  freely, 
to  begin  with  questions  about  whether  they  have  all  they  need  for  their  comfort, 
to  pass  to  some  of  the  least  irritating  topics,  such  as  will  most  likely  elicit  a  pleasant 
answer  and  create  a  congenial  starting  point./  In  perfect  privacy  and,  as  Head  says, 
with  the  choice  of  a  quiet  confidential  hour  and  the  precaution  of  changing  the  sub¬ 
ject  when  irritation  begins  to  adulterate  the  account,  and  before  the  patient  has 
been  exposed  to  the  influences  of  the  ever  present  blase  fellow  patient,  the  state¬ 
ments  can  usually  be  obtained  quite  fully,  often  with  a  feeling  of  relief  in  the  patient, 
and  a  distinct  gain  in  the  relation  between  physician  and  patient.  That  any  chances 
for  self-humiliation  must  be  eased  with  verbal  suggestion  and  that  any  appearance 
of  obnoxious  ridicule  or  dictation  or  correction  and  unnecessary  argument  must  be 
avoided,  should  not  require  special  insistence.  It  certainly  requires  a  great  deal  of 
knowledge  of  man  to  choose  the  right  moments  and  it  is  to  such  an  extent  a  matter 
of  inborn  tact,  that  it  is  doubtful  whether  any  written  rules  can  do  more  than  bring 
out  in  a  more  definite  order  that  which  one  has  already. 


Privacy,  absence  of  hurry,  frequent  change  of  topic,  with  some 
deliberate  padding  to  ease  the  strain,  particularly  “when  irrita¬ 
tion  begins  to  adulterate  the  account/'  and  yet  through  all  a  clear 
conception  on  the  part  of  the  interviewer  that  a  certain  goal  mu: 
if  possible  be  reached,  and  a  slow,  steady,  gentle  pressure  towar 
that  goal — this,  in  brief,  is  our  program.  Giving  the  client  all  the 
time  he  wants  often  leads  to  that  fuller  self-revelation  which  saves 
our  time  and  his  in  the  long  run.  Pressure  of  work!  Lack  of 
time!  How  many  failures  in  treatment  are  excused  by  these  two 
phrases!  But,  wherever  else  the  plea  of  lack  of  time  may  be  valid, 
it  is  peculiarly  inappropriate  at  this  first  stage,  for  no  worker  ever 
has  leisure  enough  in  which  to  retrieve  the  blunders  that  result 


115 


SOCIAL  DIAGNOSIS 


inevitably  from  a  bad  beginning.1  Save  time,  if  need  be,  at  some 
stage  of  treatment,  but  not  at  the  First  Interview.  “The  physician 
who  comes  in  like  a  gust  of  wind/'  says  Dr.  Paul  Dubois,  “looks  at 
his  watch,  and  speaks  of  his  many  engagements,  is  not  cut  out  to  prac¬ 
tice  this  psychotherapy.  1 1  is  necessary,  on  the  contrary,  that  the  pa¬ 
tient  should  have  the  impression  that  he  is  the  only  person  in  whom 
the  physician  is  interested,  so  that  he  may  feel  encouraged  to  give 
him  all  his  confidences  in  peace.”  And  again,  “Let  your  patient 
talk;  do  not  interrupt  him  even  when  he  becomes  prolix  and  diffuse. 
It  is  to  your  interest  as  well  as  his  to  study  his  psychology  and  to 
lay  bare  his  mental  defects.  Help  him,  however,  to  get  on  the 
right  road,  and  to  give  correct  expression  to  his  thoughts.”2  “A 
great  many  witnesses,”  says  Gross,  “are  accustomed  to  say  much 
and  redundantly,  and  again,  most  criminal  justices  are  accustomed 
to  try  to  shut  them  off  and  to  require  brief  statements.  That  is 
silly.”3  This  ability  to  feel  and  to  show  concentrated  interest  in  a 
client’s  individual  problem  is  a  fundamental  condition  of  good 
social  case  work. 

The  following  illustrations  gathered  from  case  workers  may 
contain  some  suggestions  as  to  method  of  approach,  though  the 
beginner  who  attempted  to  copy  them  instead  of  trying  to  under¬ 
stand  the  spirit  behind  them  would  be  making  a  mistake.  Further 
illustrations  will  be  found  in  the  reports  of  First  Interviews  in 
Appendix  I. 

An  agent  for  a  state  department  for  dependent  children  says  that  it  is  impossible 
to  “frame  up”  any  introductory  speech.  She  never  knows  what  she  is  going  to  say 
until  she  sees  her  client  face  to  face.  She  was  sent  to  visit  a  woman  who  had  lost 
sight  of  her  eight-year-old  illegitimate  child  for  a  long  time.  Through  relatives 
the  agent  had  been  able  to  trace  the  mother,  who  had  married  and  now  had  a  young 
baby.  She  found  the  woman  in  a  neat  flat,  and  said  at  once,  “  I  have  come  on  a 
most  unfortunate  errand  and  I  wish  that  it  had  not  been  necessary  for  me  to  come; 
won’t  you  let  me  come  in,  please,  for  I  feel  sure  that  you  would  rather  that  we  were 
not  overheard.”  When  she  went  into  the  kitchen  where  the  little  baby  was  in  a 
cradle,  she  spoke  to  the  child  and  talked  to  the  mother  about  it  until  the  mother 
was  more  at  her  ease;  then  she  told  the  object  of  her  visit.  The  mother  at  first 
tried  to  deny  the  relationship,  but  finally,  when  she  realized  that  the  agent  was  sure 

1  For  a  fuller  discussion  of  the  time  element  in  diagnosis  see  Chapter  XVI II, 
Comparison  and  Interpretation,  p.  361. 

2  Psychic  Treatment  of  Nervous  Disorders,  pp.  242-3. 

3  Criminal  Psychology,  p.  18. 

I  16 


THE  FIRST  INTERVIEW 


of  her  position,  she  acknowledged  the  child  and  promised  to  pay  regularly  for  its 
care. 

A  district  secretary  of  an  associated  charities  in  her  first  interview  with  Mrs.  G 
found  her  “very  melancholy  and  at  first  reserved  and  silent.”  The  six-year-old 
little  girl  who  was  present  was  wearing  spectacles.  Pleased  at  the  perfectly  natural 
interest  shown  in  Bessie,  in  her  attempts  at  writing,  in  the  history  of  her  eyes,  etc., 
the  mother  soon  thawed  out,  and  began  to  tell  her  story. 

An  associated  charities  worker  who  had  learned  to  be  leisurely  and  had  also 
learned  to  avoid  points  of  irritation  tells  of  an  old  woman  who  entered  her  office 
with  the  exclamation,  “Now,  ma’am,  don’t  begin  by  telling  me  to  go  to  the  alms¬ 
house,  because  that’s  just  what  I  don’t  want  to  do.”  There  was  a  circus  parade 
going  by,  and  the  secretary  said,  “Well,  anyway,  let’s  go  and  see  the  parade.” 
After  watching  the  parade  about  half  an  hour,  they  started  back  to  the  office,  and 
the  woman,  catching  hold  of  her  sleeve,  said,  “Now,  I  just  want  to  say  I  am  willing 
to  go  to  the  almshouse  if  you  think  it  best.” 

An  S.  P.  C.  C.  worker  who  has  much  to  do  with  wayward  girls  gets  them  seated 
in  the  best  chair  and  “mentally  comfortable”  through  friendly  chatter  before  she 
begins  to  talk  to  them  about  the  painful  happenings  that  have  brought  them  to 
her  desk. 

There  entered  a  charity  organization  society’s  office  one  day  a  woman  soon  to 
become  a  mother  who  demanded  a  warrant  for  the  arrest  of  her  husband  instanter. 
She  had  no  time  to  waste;  the  children  would  be  coming  home  from  school  and  must 
have  their  luncheon.  The  secretary  looked  at  her  watch  and  said  quietly,  “School 
is  not  dismissed  before  twelve  o’clock.  You  have  a  whole  hour  and  a  quarter  before 
your  children  can  possibly  get  home.  Do  sit  down  and  make  yourself  comfortable.” 
Then,  seizing  the  natural  opening,  “Where  do  the  children  go  to  school?”  This  led 
on  naturally  to  a  great  deal  of  talk  about  the  children,  before  the  irritating  behavior 
of  her  husband  was  allowed  a  full  half-hour’s  elucidation. 

Dr.  William  Healy  says  of  his  interviews  with  the  parents  of  juvenile  delinquents: 
“The  opening  of  the  interview  with  some  such  friendly  and  reasonable  statement 
as  the  following  has  been  found  in  itself  to  have  a  rationalizing  effect.  One  may  say : 
‘Well,  you  people  do  seem  to  have  a  difficult  affair  on  your  hands  with  this  boy. 
Let’s  sit  down  and  talk  it  all  over,  and  study  it  out  together — how  it  all  began  and 
what’s  going  to  happen.  I’m  at  your  service.  Did  you  ever  think  it  all  out  care¬ 
fully?’  .  .  .  The  response  is  nearly  always  gratifying.  The  attitude  of  all 

concerned  becomes  much  the  same  as  when  the  family  physician  makes  a  complete 
study  and  inquiry  into  the  possible  causes  for  an  obscure  ailment  or  defect.  We 
get  accounts  of  characteristics,  and  environments,  and  forebears,  and  other  antece¬ 
dents,  and  even  histories  of  offenses  unknown  to  the  authorities,  that  throw  often 
a  great,  new  light  on  what  should  be  done  with  and  for  the  offender.  Just  this 
alone  shows  how  vastly  necessary  it  is  to  have,  as  in  any  other  businesslike  endeavor, 
the  attitude  that  wins  success.”1 

With  regard  to  interviews  with  people  not  born  in  this  country,  some  workers, 

1  The  Individual  Delinquent,  p.  35. 

I  17 


SOCIAL  DIAGNOSIS 


who  happen  to  have  many  applications  from  immigrants  coming  from  one  part  of 
Europe,  provide  their  offices  with  maps  of  that  region.  A  large  map  of  Ireland, 
showing  the  smaller  places,  hangs  in  a  certain  district  office.  Often  the  district 
secretary  and  an  exiled  Irishman  pore  over  it  together  to  find  the  mark  which  indi¬ 
cates  the  whereabouts  of  his  native  hamlet.  In  one  of  the  district  offices  of  another 
charity  organization  society — an  office  in  the  Italian  quarter — clients  who  came 
originally  from  the  vicinity  of  Rome  and  those  from  small  villages  in  the  south  of 
Italy  are  often  reminded  of  the  old  life  and  started  talking  about  it  by  two  pictures 
on  the  wall,  one  Roman  and  one  a  country  scene. 

Where  interviewer  and  interviewed  cannot  speak  the  same  lan¬ 
guage  the  approach  is  doubly  difficult.  The  objections  to  making 
it  through  the  English-speaking  small  children  of  the  family  are 
obvious  enough,  though  this  is  often  done.  Some  large  organiza¬ 
tions  employ  case  workers  of  the  several  nationalities  from  which 
they  have  the  largest  number  of  non-English-speaking  clients. 
Where  these  workers  know  more  about  the  foreign  language  than 
they  do  about  the  special  problems  of  the  immigrant  or  about 
social  work,  the  results  are  not  happy,  but  it  is  becoming  increas¬ 
ingly  possible  to  find  case  workers  with  the  double  equipment. 
The  use  of  interpreters  is  an  expedient  which  is  full  of  difficulty. 

“  He  is,  of  course,  a  necessary  evil,"  says  Miss  Ida  Hull  of  the  interpreter  in  a 
paper  on  South  Italians  already  quoted,  “unless  the  social  worker  himself  speaks 
Italian  and  understands  the  dialects.  The  professional  interpreter  is  ubiquitous. 
Since  he  usually  represents  himself  as  the  friend  of  the  family  it  is  not  always  easy 
to  determine  just  what  his  standing  in  the  case  really  is.  Appearances  are  often 
deceptive,  as  he  may  live  in  the  neighborhood  and  may  respond  when  the  family 
calls  from  the  window.  Such  professional  interpreters  are  retained  by  their  clients, 
not  to  translate  the  family’s  statement,  but  to  achieve  some  desired  end.  They  soon 
come  to  know  about  what  sort  of  story  will  win  attention,  and  to  act  accordingly. 
They  receive  from  fifty  cents  to  five  dollars  a  trip,  or  sometimes  a  lump  sum  for  a 
certain  result,  be  it  easy  or  difficult  to  attain.  One  such  interpreter,  in  a  burst  of 
indignation  against  a  client  ‘friend’  who  had  not  paid,  spoke  of  a  widower  who  had 
been  a  ‘perfect  gentleman’  and  had  at  once  handed  over  the  ten  dollars  which  she 
had  asked  for  inducing  the  city  to  take  charge  of  his  children.  (And  the  Associated 
Charities  thought  it  had  been  responsible  for  that!)  Since  these  professionals 
‘repeat’  they  gradually  become  known  for  what  they  are, — sometimes  fairly  honest 
and  sometimes  utterly  unreliable;  but  always,  of  course,  in  the  work  as  a  business 
proposition. 

“The  interpreter  who  may  be  considered  a  prominent  citizen,  and  who  goes  out 
to  interpret  only  when  he  has  a  personal  end  to  gain,  is  a  more  perplexing  factor. 
His  connection  with  the  problem  is  doubly  difficult  to  discover  when  he  adds  the 
role  of  interpreter.  One  such  man,  of  good  business  reputation,  came  to  ask  the 

1 18 


THE  FIRST  INTERVIEW 


assistance  of  the  Associated  Charities  for  a  young  woman  in  trouble,  who  had  been 
given  his  address  in  another  city  and  who  was  then  stranded  and  alone  except  for  the 
shelter  which  he  was  forced  to  give  temporarily.  He  stated  the  case  briefly,  and  a 
call  was  promised  and  planned  for  an  hour  when  it  was  hoped  that  he  would  be  out. 
He  was  on  hand,  however.  To  the  first  question,  ‘How  long  has  she  been  in  this 
country?’  the  girl  replied  in  Italian  ‘three  months.’  Her  business  manager  turned 
to  the  investigator  and  translated  ‘one  year.’  When  the  investigator  replied  ‘but 
tre  mesi  does  not  mean  one  year,’  and  added  that  she  understood  Italian,  the  inter¬ 
view  was  really  over  though  it  took  a  half  hour  of  polite  interchange  before  it  ap¬ 
peared  to  be  terminated;  and  then  this  prominent  citizen  had  decided  to  assume 
all  responsibility  himself. 

“Many  investigators  try  to  secure  as  interpreter  an  Italian  connected  with  some 
sort  of  social  work.  This  seems  the  easiest  way  at  the  outset,  but  there  are  disad¬ 
vantages.  Such  an  interpreter  is  almost  certain  to  explain  rather  than  to  translate. 
While  much  explanation  may  be  necessary,  all  investigators  will  certainly  want  to 
know  just  what  the  family  said  as  well  as  what  they  meant  by  what  they  said.  Then 
it  may  very  well  happen,  that,  in  proportion  as  the  interpreter  can  speak  authori¬ 
tatively,  the  conduct  of  the  case  falls  into  his  hands.  A  first  investigation  can  hardly 
be  conducted  as  a  partnership  enterprise.  An  instance  of  the  failure  of  such  an 
attempt  concerns  a  most  competent  and  co-operative  Italian  social  worker  who  acted 
as  interpreter  in  the  case  of  a  deserted  wife.  This  wife,  when  asked  if  she  had  men 
lodgers,  replied  in  the  negative,  and  then  the  investigator  begged  for  further  ques¬ 
tions  as  to  the  owners  of  three  coats,  all  in  the  same  stage  of  decay,  which  were 
hanging  in  a  bedroom.  Instead  of  pursuing  that  subject,  however,  the  interpreter 
stopped  to  explain  in  detail  that  a  Sicilian  wife  could  not  keep  men  boarders  in  the 
absence  of  her  husband,  as  such  a  course  would  be  regarded  as  highly  improper. 
The  interpreter  regarded  further  questions  along  that  line  as  insulting  and  the 
investigator  could  not  courteously  press  the  point.  The  information  given  as  to 
Sicilian  etiquette  was  unimpeachable;  but,  alas!  later  developments  showed  that 
this  particular  Sicilian  woman  had  done  many  things  which  could  not  be  sanctioned 
even  by  less  rigid  codes  of  conduct. 

“Picking  up  an  interpreter  at  random  is  a  dangerous  expedient.  The  difference 
in  dialects  may  make  it  impossible  for  the  family  and  interpreter  to  understand 
each  other  well.  Then  the  family  may  object  for  a  variety  of  reasons  to  telling 
their  troubles  to  that  particular  person.  The  chance  interpreter  may  be  a  gossip 
in  whom  the  family  cannot  safely  confide;  she  may  be  a  creditor;  she  may  seem 
their  social  inferior  because  of  having  been  born  a  few  miles  too  far  south. 

“Perhaps  on  the  whole  the  best  way  to  arrange  for  the  first  interview  is  for  the 
investigator  to  go  to  the  house  and  to  look  so  brim  full  of  interesting  things  to  say 
that  the  family  will  seek  the  interpreter  they  prefer.  The  one  they  choose  is  likely 
to  be  in  sympathy  with  their  point  of  view  and  to  try  to  present  it.  If  the  first 
interpreter  proves  inadequate,  others  may  be  sought  for  later  interviews.  Checking 
one  by  another  is  a  way  of  correcting  interpreters  in  their  mistakes,  both  intentional 
and  unintentional,  but  the  most  successful  way  of  treating  the  interpreter  problem 
is  to  learn  the  language  and  so  either  to  eliminate  or  to  control  them.” 


SOCIAL  DIAGNOSIS 


2.  Clues  and  Questions.  A  number  of  case  workers  have  been 
asked  to  write  as  careful  an  analysis  as  possible  of  the  process 
of  some  of  their  own  recently  held  First  Interviews,  stating  the 
physical  and  social  conditions  under  which  the  interview  took 
place;  the  first  five  minutes  of  getting  under  way;  the  direction 
taken  by  the  first  full  flood  of  talk;  any  efforts  made  to  direct  the 
stream;  the  obstacles  encountered  and  how  overcome;  the  dis¬ 
tinct  points  of  illumination  and  insight,  and  how  these  were  led  up 
to;  the  clues  to  the  experience  and  points  of  view  of  others  in¬ 
terested  in  their  client,  and  how  these  clues  were  secured;  im¬ 
patient  pressure,  if  any,  for  premature  action,  and  how  it  was  set 
aside;  possible  centers  of  soreness  and  how  they  were  avoided; 
and  what  understanding  about  the  next  meeting,  if  any.  As  might 
have  been  anticipated,  some  of  the  best  interviewers  proved  to  be 
the  worst  possible  analyzers  of  the  process,  but  a  few  of  the  analyses 
secured  are  given  in  Appendix  I. 

These  analyses  were  not  needed  to  prove,  though  they  do  prove, 
that  the  worker  must  at  once  begin,  as  soon  as  the  interview  opens, 
to  draw  certain  tentative  conclusions — they  are  little  better  than 
conjectures  at  this  stage — and  must  also  be  prepared  to  abandon 
these  as  the  interview  and  the  later  story  develop.  Take,  for 
instance,  one  of  the  analyses  at  hand  in  which  a  man,  out  of  work 
for  several  months,  applies  to  a  family  agency  in  a  city  to  which 
he  had  just  come  with  his  wife  and  child.  In  answer  to  the  first 
comment  of  the  interviewer  that  she  understands  he  is  a  locomo¬ 
tive  engineer,  he  volunteers  the  statement  that  he  was  disqualified 
by  “nervous  trouble”  in  November  and  has  not  worked  since. 
At  once  there  comes  to  mind  some  outline  of  the  things  that  the 
vague  phrase  “nervous  trouble”  might  cover.  Is  the  disease 
physical?  Mental?  A  result  of  some  habit,  of  alcoholism  or 
drug-taking?  The  very  first  line  of  questioning  takes  the  direc¬ 
tion  of  finding  out  what  kind  of  medical  care  the  man  has  had. 
This  brings  the  name  and  address  of  a  doctor  in  another  town, 
whose  advice  can  be  sought  Fater.  But  the  possibilities  further 
suggested  by  “nervous  trouble” — such  as  drug  habits,  etc. — lead 
the  worker  somewhat  later  to  cover  carefully  the  man's  where¬ 
abouts  since  his  discharge,  his  means  of  maintaining  his  family, 
his  reasons  for  leaving  his  farmer  father  with  whom  he  and  his 

120 


THE  FIRST  INTERVIEW 


family  have  been  staying,  etc.  At  any  moment,  either  during  the 
interview  or  later,  information  obtained  may  show  that  some  one 
or  more  of  the  hypotheses  that  prompted  the  questions  asked 
are  untenable.  They  must  never  be  clung  to  obstinately.  This 
warning  has  been  given  in  earlier  chapters,  but  it  will  bear  repeti¬ 
tion. 

In  the  interview  with  a  deserted  wife,  given  in  Appendix  I,  this 
same  process  appears  again  and  again.  Husband  and  wife  got  on 
well  when  they  were  in  another  city,  the  client  says.  Though  the 
man  may  not  return  and  though  further  inquiry  may  easily  prove 
that  the  statement  is  a  mistaken  one,  still  make  a  mental  note  of  it. 
It  may  have  a  bearing  upon  diagnosis;  it  may  have  a  bearing  upon 
treatment.  If  the  man  “got  her  into  trouble”  before  they  were 
married,  as  the  wife  states,  this  suggests  complications  with  rela¬ 
tives  on  both  sides  of  the  house,  and  a  forced  marriage,  perhaps, 
in  which  there  was  little  affection.  The  very  next  questions  follow 
this  line  of  thought,  making  allowance,  however,  for  the  chance 
that  after  the  children  came  the  father’s  sense  of  family  responsi¬ 
bility  developed.  This  wife  comes  to  the  associated  charities 
office  homeless,  after  a  violent  quarrel  with  her  mother.  But  has 
she  no  other  place  to  go?  Yes,  there  are  relatives  and  some  of 
them  can  be  and  are  communicated  with  by  telephone.  The  fact 
that  they  have  telephones  is  in  itself  an  indication  of  certain 
material  resources,  at  least,  and  so  on. 

These  processes  of  reasoning,  of  inference,  of  making  a  first 
hypothesis  as  a  tentative  starting  point,  have  been  considered  in 
Part  I,  and,  following  the  gathering  of  evidence,  its  correlation, 
as  discussed  much  later,  involves  a  reweighing  of  inferences  al¬ 
ready  drawn;  but  any  interview  in  which  the  social  worker  was  not 
using  his  reasoning  faculties  in  this  way  every  moment  would  be 
lifeless  and  useless.  The  habit  of  weighing,  comparing,  consider¬ 
ing  must  be  understood  to  belong  to  all  the  processes  described  in 
every  part. 

It  would  seem,  from  the  analyses  received,  that  interviewers 
may  be  divided  into  those  who  follow  a  fairly  fixed  order  of  pro¬ 
cedure,  and  those  who  begin  wherever  the  situation  suggests  a 
natural  opening  and  let  the  interview  develop  as  it  will,  bringing  it 
back  from  time  to  time  to  cover  some  absolutely  essential  point, 

I  2  I 


SOCIAL  DIAGNOSIS 


but  checking  off  mentally  the  unasked  questions  as  they  happen 
to  be  answered.  Under  some  conditions,  when  conducting  an 
interview  through  an  interpreter  for  instance,  direct  queries  are 
unavoidable.  Both  of  these  groups  recognize  the  disadvantages 
of  rapid-fire  questioning,  however,  and  realize  that  the  more 
clearly  an  investigator  has  in  mind  the  things  that  he  ought  to 
know,  the  more  completely  can  he  avoid  the  manner  of  the  official 
examiner;  they  differ  in  that  the  one  holds  a  loose  rein  and  the 
other  a  tight  one. 

One  interviewer  in  the  “ fixed  order”  group  tries  if  possible  to 
get  the  person  interviewed  to  begin  with  his  birthday  and  develop 
his  story  in  chronological  order.  Another,  though  not  holding 
herself  strictly  to  any  established  order,  strives  usually  to  get  the 
“family  make-up”  first,  including  names,  ages,  and  birthplaces  of 
the  father,  mother,  and  each  child,  and  of  any  other  members  of 
the  family  group.  Birthplaces  suggest  previous  residences.  She 
then  tries  to  muster  in  her  own  mind  what  she  calls  the  “physical 
and  industrial  resources,”  the  transition  from  the  first  to  the  second 
grouping  being  easily  made  by  some  such  remark  as,  “Well,  this 
certainly  is  a  big  family.  How  do  you  manage?  What  is  your 
husband  doing?”  This  leads  on  to  earnings,  employers,  physical 
condition,  etc.  The  beginner  is  often  even  more  precise  than  this. 
Not  only  does  he  memorize  what  is  known  as  the  face  card  of  the 
case  record  that  he  will  later  have  to  fill  in,  but  he  makes  the  mis¬ 
take  too  often  of  allowing  his  interview  to  be  shaped  by  the  acci¬ 
dents  of  the  size  and  arrangement  of  the  card.1 

There  is  no  one  way  of  conducting  a  First  Interview,  and  it 
may  be  that  upon  occasion  any  one  of  the  foregoing  methods  might 
have  to  be  resorted  to,  but  the  more  flexible  method  of  the  worker  who 
keeps  his  mind  open  to  all  natural  avenues  of  approach  and  utilizes 
them  to  the  full  is  likely  to  yield  better  results  in  the  long  run  and 
in  the  majority  of  cases.  An  interviewer  who  is  an  advocate  of 
the  freer  method  writes  that  she  lets  the  story  go  on  as  it  will, 
beginning  anywhere  that  may  suggest  itself  by  accident  or  by  the 
situation  at  the  time  of  her  arrival,  but  adds  that  she  has  trained 

1  “To  those  of  us  who  began  without  a  face  card,”  writes  a  case  worker,  “and 
made  one  for  our  convenience,  the  beginners  who  allow  themselves  to  be  tied  down 
by  it  seem  tragic  objects.  Anything  we  can  do  to  disabuse  their  minds  of  the  idea 
that  they  get  information  in  order  to  fill  out  the  card  will  be  well  worth  while.” 

122 


THE  FIRST  INTERVIEW 


herself  to  put  the  facts  as  she  gets  them  in  a  chronological  scheme, 
and  to  keep  in  mind  gaps  that  must  be  filled — dates,  addresses, 
specific  names,  numbers,  etc. — as  the  opportunity  arrives.  In 
one  hospital  social  service  department,  two  workers  specializing 
in  nervous  diseases  use  different  methods.  One  keeps  quite  closely 
to  a  carefully  prepared  outline;  the  other  starts  with  the  problem 
because  of  which  the  patient  is  referred.  If  her  department  has 
been  asked  to  help  in  finding  more  suitable  employment,  for  in¬ 
stance,  she  takes  employment  for  her  first  line  of  questioning  and 
leads  the  patient  into  other  avenues  through  this  natural  approach. 
She  prefers  direct  questions  to  subtler  methods,  stopping  to  explain 
the  reason  for  each  question  whenever  this  is  necessary. 

Everything  that  has  been  said  in  earlier  chapters  about  methods 
of  questioning,  and  more  especially  about  leading  questions,1 
applies  especially  to  the  First  Interview.  Not  only  should  we 
frame  our  questions  in  such  a  way  as  to  bring  truthful  replies, 
but  we  should  put  aside,  to  be  sought  elsewhere,  all  information 
that  can  be  secured  just  as  well  or  better  from  an  outside  source. 
Employers  and  fellow  workmen  are  better  witnesses  as  to  a  man’s 
habits  than  he  or  his  immediate  family.  Ages  and  property — 
things  about  which  all  sorts  and  conditions  of  men  are  secretive — 
are  often  matters  of  public  record.2  Economy  of  means  marks  the 
skilled  worker;  he  asks  no  useless  questions,  he  gets fewer  mis¬ 
leading  replies.  Misleading  replies  are  never  just  that;  they  are 
barriers  between  ourselves  and  those  whom  we  would  help,  which 
is  the  best  of  all  reasons  for  aiding  our  clients  to  bear  truthful 
witness. 

Certain  questions  must  be  asked,  of  course,  but  it  is  important 
to  bring  them  forward  at  the  right  time.  When  we  ask  the  head 
of  the  family  seeking  material  assistance  whether  there  are  any 
relatives  able  to  assist,  he  will  almost  invariably  say  “no,”  be¬ 
cause  his  mind  is  bent  upon  securing  other  help.3  Note  the  mis- 

1  See  p.  71  sq. 

2  “  I  remember  an  instance  of  an  agent’s  getting  first  one  story,  then  another, 
and  then  another,  about  the  property  left  and  the  guardianship  of  the  children, 
when  a  visit  to  the  probate  court  in  the  first  instance  would  have  saved  a  great  deal 
of  trouble  and  made  the  matter  clear.”  — From  a  private  letter. 

See  upon  this  point  Chapter  XIII,  Documentary  Sources. 

3  Sometimes  clients  are  quite  sincere  in  saying  that  their  relatives  will  not  or 
cannot  help  or  advise  and  yet  they  are  mistaken.  “An  old  man  assured  a  worker 

123 


SOCIAL  DIAGNOSIS 


take  traceable  to  this  cause  made  in  the  interview  reported  in 
Appendix  I,1  and  how  quickly  the  ground  lost  was  recovered. 

All  of  our  clues  are  best  won  as  “  by-productsof  cordial  inter¬ 
course/’  but  a  few  of  them  are  tqo  important^to  be  omitted. 
Those  that  are  most  frequently  needed  from  the  initial  interview 
are  (a)  relatives,  (b)  doctors  and  health  agencies,  (c)  schools, 
(d)  employers,  past  and  present,  and  (e)  previous  residences  and 
neighborhoods. 

(a)  By  far  the  most  difficult  clues  to  secure  usually  are  the 
names  and  whereabouts  of  relatives,  but  for  reasons  explained  in 
the  chapter  on  Relatives  as  Sources  these  are,  outside  the  im¬ 
mediate  family,  often  our  most  important  sources  of  information.2 
The  questioning  which  associates  relatives  and  the  idea  of  assist¬ 
ance  is,  as  just  noted,  psychologically  unsound,  but  the  formal 
question,  “  Have  you  any  relatives  in  this  city  or  elsewhere?"  may 
also  bring  vague  information  about  one  or  two  and  nothing  about 
the  most  important  ones,  namely,  those  that  are  the  most  intelli¬ 
gent  sources  of  information.  Clients  sometimes  develop  no  small 
degree  of  ingenuity  in  keeping  the  social  workers  who  are  inter¬ 
ested  in  them  and  their  relatives  far  apart.  After  all  plans  of 
treatment  have  failed,  it  is  too  late  to  begin  looking  up  the  only 
people  who  can  fill  in  gaps  in  previous  history. 

Information  about  relatives  comes  most  easily  in  the  discussion 
of  earlier  and  happier  times,  in  the  talk  about  the  normal  rather 
than  the  abnormal  periods  of  the  family  history.  After  making 
mental  note  of  them  during  this  part  of  the  interview,  it  is  com- 


that  he  had  absolutely  no  one  who  could  help  him;  he  had  lived  a  solitary  life, 
collecting  natural-history  specimens  for  a  livelihood  and  studying  the  Bible  and 
preaching  in  all  his  leisure  hours,  until  he  could  neither  collect  more  insects  nor  sell 
those  he  had  accumulated.  After  much  persuasion  he  was  induced  to  bring  the 
address  of  some  relations  in  Canada  of  whom  he  had  long  lost  sight,  but  he  only 
did  it  because  he  thought  the  lady  had  taken  a  kindly  interest  in  him  and  that  he 
might  as  well  satisfy  her  whims — just  as  in  the  same  grateful  spirit  he  brought  her 
some  pretty  green  beetles  as  a  gift.  The  dreamy,  gentle  old  man  was  perfectly 
honest  in  thinking  this  inquiry  useless;  but  by  return  of  post  there  came  £10  from 
Canada,  and  news  that  the  applicant  was  entitled  to  a  sum  of  money  under  a  will, 
which  sum  had  been  waiting  for  him  until  he  could  be  found.” — Lawrence,  Miss  K.  L., 
in  the  London  Charity  Organisation  Review  for  March,  1912,  p.  121. 

1  See  p.  464  sq. 

2  The  term  "relatives”  as  used  throughout  these  chapters  applies  to  those 
kindred  and  connections  by  marriage  who  do  not  now  form  a  part  of  the  client’s 
immediate  family  group,  or  share  his  family  table. 

124 


THE  FIRST  INTERVIEW 


paratively  easy  later  on  to  go  back  and  say,  “Where  are  your 
brothers  and  sisters  now?”  checking  them  off  mentally  as  de¬ 
ceased,  as  in  the  old  country,  as  in  this  country,  etc.1 

“Years  ago,”  said  an  experienced  case  worker  at  a  charity  organization 
meeting,  “before  this  society  was  founded,  I  became  interested  in  a  young  girl  of 
seventeen.  She  appealed  to  me  greatly.  She  had  no  mother,  and  claimed  that  her 
father  was  not  good  to  her,  and  her  brother  and  sister  far  away.  She  was  attractive 
and  much  alone.  I  knew  no  one  who  knew  more  of  her  than  I  did  myself,  and  was 
often  puzzled  how  to  advise  her.  She  was  anxious  to  take  a  vacant  position  in  a 
family  known  to  me,  and  after  some  consultation  she  went.  It  was  the  mistake  of 
a  lifetime.  I  see  her  now  from  time  to  time  and  never  without  realizing  the  mistake 
I  made  in  permitting  her  to  enter  that  family.  If  an  agent’s  investigation  could  have 
preceded  my  first  visit,  the  agent  would  have  made  a  chance  to  see  the  father, 
would  have  learned  the  fact  that  the  brother  and  sister  were  less  than  a  mile  away, 
that  the  girl  had  made  so  much  trouble  in  the  household  that  she  was  forbidden 
the  house,  and  that  the  father  was  greatly  puzzled  to  know  what  to  do  with  her. 
With  this  knowledge,  how  much  more  wisely  I  could  have  advised  her!” 

There  are  exceptional  circumstances  in  which  the  looking  up  of 
relatives  may  do  more  harm  than  good.  It  is  usually  possible  to 
learn  from  some  unbiased  source  whether  the  circumstances  are 
as  exceptional  as  they  appear  to  be. 

One  case  record  examined  contains  the  formal  vote  of  an  associated  charities 
district  conference  that  a  certain  woman  “is  too  sick  to  be  urged  to  give  the  addresses 
of  the  relatives  in  Seattle  at  present.”  Later  they  were  secured  without  difficulty. 

A  woman’s  relatives  were  not  seen  by  the  agent  of  a  charity  organization  society 
because,  according  to  her,  they  had  disapproved  of  her  marriage  and  she  would  not 
for  the  world  have  them  know  that  her  husband  was  out  of  work  and  applying  for 
aid.  After  persistent  effort  a  good  job  was  found  for  him.  Four  months  later  his 
wife  applied  because  he  had  deserted  her  and  her  two  small  children  for  the  third 
time,  going  off  this  time  with  another  woman.  The  wife  had  been  terrorized  by 
him  into  refusing,  at  the  time  of  the  first  application,  to  give  her  mother’s  name 
and  address.  A  visit  to  the  mother  revealed  a  long  history  of  cruelty  and  abuse 
from  the  man.  In  other  words,  four  months  had  been  wasted  in  securing  adequate 
protection  for  this  family — the  real  clients  from  a  social  work  point  of  view — because 
the  diagnosis  that  should  have  read,  “Wife  and  children  in  need  of  protection  from 
a  vagabond  husband  and  father,”  read  instead,  “Hard-working  head  of  family  out 
of  work.”  The  former  employers  seen  had  shielded  him;  his  mother-in-law  would 
not  have  done  so. 

(b)  Doctors  and  health  agencies  (Chapter  X)  come  naturally 

1  As  noted  elsewhere,  relatives  often  appear  at  times  of  sickness  or  of  death. 
The  doctor  and  nurse  may  be  able  to  name  relatives  that  they  have  seen  at  such 
times. 


125 


SOCIAL  DIAGNOSIS 


and  without  difficulty,  usually,  in  the  unfailingly  interesting  de¬ 
tails  of  sickness. 

(c)  Schools  and  teachers  (Chapter  XI)  are  seldom  withheld  when 
there  is  any  talk  whatever  about  the  children. 

(d)  Employers,  past  and  present,  (Chapter  XII)  come  readily 
enough  usually,  especially  when  there  is  any  question  of  securing 
more  work  or  of  accounting  for  a  decrease  of  income.  Former 
employers  that  are  not  mentioned,  however,  are  even  more  im¬ 
portant  than  those  that  are,  if  an  all-round  view  is  to  be  had.  It 
must  be  remembered  that  the  workmen  of  a  large  concern  are  often 
known  by  number  instead  of  name,  and  that  for  purposes  of  iden¬ 
tification  it  is  necessary  further  to  have  the  name  of  the  particular 
shop  and  of  its  foreman. 

(e)  Previous  residences  and  neighborhoods  (Chapter  XIV)  come 
most  easily  in  the  discussion  of  present  rent,  etc.  The  family  has 
been  in  the  present  house  or  apartment  so  many  months,  and  be¬ 
fore  that  they  lived  at  such  a  place,  but  the  addresses  of  the  pre¬ 
vious  residences  are  often  not  specific  and  it  is  important  to  note 
them  as  accurately  as  possible.  Sometimes  the  vagueness  can  be 
remedied  by  the  use  of  the  city  directory  and  by  inquiry  of  outside 
sources.1 

We  must  not  be  so  bent  upon  getting  clues  to  outside  information 
that  we  miss  our  way  to  the  even  more  important  inside  truths  of 
personality — to  our  client’s  hopes,  fears,  plans,  and  earlier  story. 
In  family  work,  we  must  have  sooner  or  later  a  pretty  clear  idea 
not  only  of  the  main  biographical  outlines  of  the  two  heads  of  the 
\  house  and  of  the  older  children,  but  some  conception  of  their  atti¬ 
tude  toward  life.  This  is  far  more  important  than  any  single  item 
in  their  story.  Families  have  their  own  plans  and  their  own  ideals 
— more  definite  ones  than  the  social  worker  realizes.  These  must 
be  understood  and  taken  into  account  from  the  beginning.  All 
our  plans  otherwise  will  surely  come  to  grief. 

3.  Taking  Notes.  The  psychological  effect  of  a  blank  space 
after  a  printed  question  is  to  suggest  the  prompt  filling  in  of  an 
answer,  whether  the  writer  knows  the  answer  or  not.  When  in- 

1  The  city  directory  for  earlier  years  can  often  be  consulted  for  previous  resi¬ 
dences  with  profit  before  the  first  visit.  For  use  of  directory  see  Chapter  XIII,  Docu¬ 
mentary  Sources,  p.  265  sq. 


126 


THE  FIRST  INTERVIEW 


vestigation  was  first  attempted  in  connection  with  the  earlier 
forms  of  charitable  service,  the  filling  in  of  a  blank  was  very  nearly 
the  whole  of  the  process.  Sometimes  the  applicant  (the  suppliant 
almost)  stood  behind  the  investigator  sitting  at  his  desk,  and  the 
latter  delivered  the  questions  over  his  shoulder  and  wrote  down  the 
answers  quite  perfunctorily.  The  natural  reaction  from  all  this — 
a  reaction  carried  farthest  by  the  charity  ofganizati°n  societies  in 
their  earlier  days — led  to  the  definite  instruction,  “Take  no  notes 
in  the  presence  of  the  poor.”  In  so  far  as  this  instruction  has 
forced  upon  a  large  group  of  social  workers  a  much  more  severe 
drill  in  keeping  clearly  in  mind  a  mass  of  details  without  the  help 
of  pen  and  paper,  it  has  been  a  good  thing.  The^ttitude  of  the 
average  citizen  toward  the  big  corporation  and  its  representatives 
has  a  quite  close  parallel  in  the  attitude  of  the  average  patient  or 
applicant  toward  social  agencies.  They  seem  powerful  imper¬ 
sonal  things,  prone  to  ignore  the  differences  of  which  the  individual 
is  so  keenly  conscious,  and  his  code  for  governing  his  relations  with 
them  is  a  modified,  a  less  loyal  code,  than  that  which  shapes  his 
relations  with  his  fellows.  One  of  the  most  important  results  of  a 
successful  First  Interview  is  the  substitution  of  a  personal  relation 
and  sense  of  loyalty  for  the  client's  standard  of  behavior  toward 
impersonal  institutions  and  agencies.  In  so  far  as  note-takirig 
emphasizes  the  impersonal  side,  it  is  wiser  to  take  no  notes  in  the 
presence  of  the  client  that  would  not  appear  to  him  at  once  as  the 
obvious  and  courteous  thing  to  do.  No  rule  can  be  laid  down, 
however.  The  nature  of  the  task  and  the  conditions  under  which 
the  interview  is  held  must  modify  our  method.  The  worker  who 
can  forget  his  pencil,  visit  a  family  for  the  first  time,  conduct  a 
First  Interview  full  of  names,  addresses,  ages  and  family /details, 
and  then  come  back  to  his  office  and  dictate  a  clear  and  accurate 
statement,  has  at  his  command  a  better  technique  than  one  who 
is  the  slave  of  a  schedule  or  blank  form.  Beginners  often  exclaim 
that  this  achievement  is  for  them  impossible;  their  memory  is  too 
poor  and  the  mere  effort  to  remember  destroys  all  spontaneity  of 
intercourse.  Almost  anyone  can  learn  to  do  it,  however,  and  it 
demands  not  half  the  self-discipline  that  dozens  of  processes  in  the 
other  arts  demand.  If  we  take  our  professional  work  seriously 
enough,  we  shall  overcome  this  obstacle  without  delay.  We  shall 

127 


SOCIAL  DIAGNOSIS 

fail  the  first  time  that  we  try,  and  in  successive  trials,  but  gradu¬ 
ally,  either  through  visualizing  our  information  or  in  some  other 
way  that  comes  more  natural  to  us,  the  memorizing  will  become 
easy.  The  ability  to  reffain  from  note-taking  does  not  mean, 
however,  that  we  should  invariably  do  so.  Both  methods  have 
their  place.  When  note-taking  during  the  interview  has  seemed 
unwise,  many  workers,  make  rough  notes  of  names,  addresses,  and 
main  heads  as  soon  as  it  is  closed.  If  they  are  going  on  from  one 
visit  to  another,  th'ey  often  stop  in  the  nearest  drug  store,  or  do 
this  in  the  trolley  car,  unburdening  the  memory  of  troublesome 
details  before  beginning  the  next  interview. 

Three  medical-social  workers  questioned  on  this  point  give  the  following  varia¬ 
tions  of  method:  The  first  feels  that  filling  out  the  face  card  of  her  record  in  the 
presence  of  a  patient  is  a  distinct  advantage,  in  that  the  patient  passes  from  the 
medical  clinic  jmto  the  social  clinic  to  find  very  much  the  same  routine  followed  in 
both.  The  si  mple  questions  and  answers,  moreover,  come  as  a  relief  after  the  physi¬ 
cal  examina  tion  of  the  clinic.  She  pursues  this  method  even  when  the  patient 
challenges/ her  reasons  for  so  doing,  on  the  ground  that,  as  she  believes  it  to  be 
reasonable,  she  should  be  able  to  explain  it  to  another.  In  certain  cases,  though 
these  are  the  exception,  she  has  to  stop  and  explain  why  after  almost  every  ques¬ 
tion.1  ' 

T’he  second  worker  agrees  with  the  foregoing  as  to  routine  questions  of  name, 
address,  age,  etc.,  but  when  the  history  becomes  more  personal  in  its  nature,  she 
is  in  the  habit  of  dropping  pen  and  pencil  and  all  that  would  tend  to  interfere  with 
Spontaneity  of  intercourse. 

The  third  worker  cannot  imagine  continuing  the  use  of  the  blank  form  where 
irritation  appears,  and  believes  that  the  question  of  writing  or  no  writing  ought  to 
be  settled  with  each  patient  separately.  “If,  when  the  doctor  brings  a  patient  to 
my  office,  he  or  she  seems  to  be  unwilling  and  hangs  back,  I  try  not  to  have  him 
even  see  the  pen  and  ink  on  my  desk.  At  another  time  the  patient  may  seem  re¬ 
sponsive  up  to  the  time  that  the  blank  and  pen  are  produced;  in  that  event  they 

1  Le  Play  says  in  La  Methode  Sociale,  1879,  p.  222,  as  quoted  by  Chapin  in 
The  Standard  of  Living  (p.  8),  that  he  always  had  the  good  will,  even  affection, 
of  families  investigated,  and  thinks  that  it  was  due  to  his  method;  he  observed 
the  following  expedients  for  gaining  the  good  will  of  the  families: 

“Not  to  be  abrupt  in  pushing  inquiries — an  introduction  from  a  well-chosen 
source  helps  in  abridging  the  preliminaries;  to  secure  the  confidence  and  sympathy 
of  the  family  by  explaining  the  public  utility  of  the  inquiry,  and  the  disinterested¬ 
ness  of  the  observer;  to  sustain  the  attention  of  the  people  by  interesting  conver¬ 
sation;  to  indemnify  them  in  money  for  time  taken  by  the  investigation;  to  praise 
with  discrimination  the  good  qualities  of  different  members;  to  make  judicious 
distribution  of  little  gifts  to  all.” 

This  is  taken  from  a  description  of  a  research  investigation  in  which  no  treat¬ 
ment  is  to  follow;  it  is  not  wholly  applicable  here,  therefore,  but  is  at  least  sugges¬ 
tive.  The  “judicious  distribution”  is  open  to  question. 

128 


THE  FIRST  INTERVIEW 


are  left  untouched.  Many  times,  however,  my  patients  take  the  written  blank  as 
a  matter  of  course,  and  when  they  do,  1  do.  Aside  from  the  question  of  idiosyncrasy 
the  ‘reason  for  referring’  should  modify  our  method,  I  believe.  The  man  or  woman 
who  wishes  to  pay  for  orthopedic  plates  a  little  at  a  time  takes  it  as  a  matter  of 
course  that  you  should  make  out  a  record  that  includes  references,  etc.  On  the  other 
hand,  the  unmarried  girl  who  has  learned  for  the  first  time  that  she  has  syphilis  or 
is  pregnant  is  filled  with  apprehension  lest  her  misfortune  become  known.  It  does 
not  seem  possible  to  me  to  lay  down  any  rule  in  our  work  for  so  delicate  a  relation 
as  the  approach  to  the  patient  in  a  medical-social  department.” 

An  S.  P.  C.  C.  agent  confirms  the  experience  of  this  third  worker.  Sometimes  she 
goes  into  a  family  and  tells  them  that  she  is  going  to  write  down  everything  they 
say,  and  that  they  will  get  into  trouble  if  she  finds  that  they  have  not  told  the 
truth.  At  other  times  she  will  not  use  a  paper  and  pencil  even  for  the  dates  of  birth 
of  the  children,  necessary  though  these  are,  getting  the  names  and  the  approximate 
ages  of  the  children  and  then  going  to  the  city  registry  of  births  for  the  accurate 
dates.  She  never  knows  until  she  actually  sees  the  people  which  method  she  is 
going  to  use.  It  is  not  a  question  of  nationality  or  of  the  circumstances  of  the  family, 
but  something  more  subtle  that  influences  her  choice. 

Of  the  unusually  full  and  almost  verbatim  records  needed  of  office  interviews 
with  delinquents  who  are  possibly  defective,  Dr.  Healy  writes,  “It  has  been  sug¬ 
gested  by  some  observers,  e.  g.,  Binet,  that  a  stenographer  should  be.  present  to 
take  down  the  subject’s  remarks  during  his  work  with  tests.  We  should  not  at  all 
agree  to  this  at  any  stage.  There  should  be  no  onlooker  or  any  third  person  even 
surreptitiously  taking  notes  when  one  is  dealing  with  a  delinquent.  We  have  come 
to  feel  that  even  the  Binet  tests  are  given  much  more  freely  when  the  psychologist 
is  alone  with  the  examinee.  To  a  considerable  extent  the  same  question  comes  up 
when  the  interviewer  himself  takes  the  words  in  shorthand.  People  all  look  askance 
when  they  know  what  they  are  saying  is  being  taken  down  word  for  word.  .  .  . 

We  have  tried  several  methods,  and  are  convinced  that  by  far  the  best  scheme  is 
to  make  little  jottings  of  words  and  phrases  and  facts  in  an  apparently  careless 
and  irregular  fashion  while  sitting  at  one’s  desk,  and  then  immediately  after  the 
interview  to  dictate  as  nearly  as  possible  the  actual  words  used.  After  a  little  prac¬ 
tice  one  uses  all  sorts  of  abbreviations  that  really  make  up  an  individual  shorthand 
system,  and  from  these  one  can  later  dictate  accurately  the  essence  of  interviews 
lasting  an  hour  or  more.  This  scheme  works  very  well  with  us,  and  rarely  arouses 
any  comment  from  the  interviewed.”  1 

4.  Premature  Advice  and  Promises.  Some  years  ago  the 
writer,  in  trying  to  train  a  new  worker,  did  not  discover  that  this 
novice’s  First  Interviews  were  crowded  with  gratuitous  advice  and 
moral  instruction,  until,  going  unexpectedly  to  her  office  one  day 
and  finding  her  alone,  she  said,  “Come,  I  am  an  applicant.  Inter¬ 
view  me.”  The  case  worker  is  indeed  fortunate  whose  records  of 


9 


1  The  Individual  Delinquent,  p.  48  sq. 

129 


SOCIAL  DIAGNOSIS 


First  Interviews,  when  read  a  few  months  after  they  have  been 
held,  reveal  no  plans  and  suggestions  that  are  made  to  seem  absurd 
in  the  light  of  further  knowledge. 

The  First  Interview  with  a  mother  who  was  seeking  help  for  herself  and  her 
two  children  reads  in  part  as  follows:  “She  was  advised  to  make  a  charge  against 
her  husband  for  non-support  at  once.  Says  her  relatives  do  not  wish  her  to.  .  .  . 

Advised  with  woman  regarding  a  position  at  service  with  the  baby  and  commitment 
of  the  older  one.  Says  she  would  not  like  this  arrangement,  is  sure  that  she  can 
care  for  the  children  as  soon  as  she  finds  a  good  position.”  It  developed  later  that 
the  man  and  woman  were  not  married  to  one  another. 

“We  have  found  that  it  is  usually  unwise  to  give  much  advice  in  a  first  inter¬ 
view,  because  the  patient  needs  to  know  us  better  that  our  advice  may  come  with 
added  force  from  his  appreciation  of  the  friendliness  of  our  motive.  Also  we  need 
to  know  the  patient  better  in  order  to  use  his  suggestibility,  which  is  often  extreme, 
to  his  best  advantage.”  Third  annual  report  of  the  Massachusetts  General  Hos¬ 
pital  Social  Service  Department,  sub-report  on  Psychiatric  Work,  1907-08^.46. 

Another  snare  for  the  feet  of  the  beginner  is  the  pressure  brought 
by  the  interviewed  for  premature  action  or  for  definite  promises 
of  action.  Any  one  way  of  setting  this  pressure  aside  is  as  much 
to  be  avoided  as  any  one  way  of  conducting  the  rest  of  the  inter¬ 
view.  A  favorite  device  is,  “My  committee  must  be  consulted/’ 
but  it  should  be  possible  to  give  a  more  specific  reason.  The  more 
completely  we  treat  our  clients  as  reasonable  beings  the  better. 

5.  Bringing  the  Interview  to  a  Close.  The  test  of  a  successful 
interview,  we  should  remember,  is  twofold.  We  must  have  suc- 
ceeded  in  getting  enough  of  the  client’s  story  and  of  the  clues  to 
other  insights  to  build  our  treatment  solidly  upon  fact;  and  we  must 
have  achieved  this,  if  possible,  without  damage  to  our  future  rela¬ 
tions,  and  with  a  good  beginning  made  in  the  direction  of  mutual 
understanding.  Interviews  that  have  covered  every  item  of  past 
history  and  present  situation  with  accuracy  and  care  can  be  total 
failures.  Interviews  that  have  led  to  an  enthusiastic  acceptance 
on  the  part  of  the  client  of  the  social  worker’s  point  of  view,  and  a 
lively  anticipation  of  much  benefit  from  future  intercourse,  can 
also  be  failures,  though  failufe  of  the  second  kind  need  not  be  so 
fatal  and  complete  as  that  of  the  first.  We  are  not  investigating 
for  the  sake  of  investigating,  but  for  the  sake  of  getting  something 
done  that  will  be  permanently  helpful. 

In  our  effort  to  build  a  solid  foundation  we  may  have  had  to  ask 

130 


THE  FIRST  INTERVIEW 


some  embarrassing  questions  and  touch  a  nerve  that  is  sore.  It  is 
most  important,  where  this  has  been  the  case,  that  in  the  last  five 
or  ten  minutes  of  the  interview  we  dwell  upon  hopeful  and  cheerful 
things,  and  leave  in  the  mind  of  the  client  an  impression  not  only 
of  friendly  interest  but  of  a  new  and  energizing  force,  a  clear  mind 
and  a  willing  hand  at  his  service.  Dr.  Meyer  is  quite  right.  If 
we  know  how  to  do  it,  the  patient’s  statements  can  usually  be  ob¬ 
tained  not  only  fully  but  with  an  actual  feeling  of  relief  on  his  part,1 
and  a  distinct  gain  in  the  relation  between  client  and  worker. 

6.  Emergency  Interviews.  There  are  cases  of  severe  illness  or 
other  emergency  in  which  action  is  too  urgently  necessary  or  the 
conditions  are  too  unfavorable  to  admit  of  more  than  a  hasty  First 
Interview.  Two  of  these  are  described  by  Miss  Helen  B.  Pendle¬ 
ton:2 

You  cannot  stop  to  find  out  whether  the  young  Slav  lying  ill  with  typhoid  in  the 
filthy  lodging  house  came  over  in  the  North  German  Lloyd  or  the  Red  Star  Line, 
or  whether  he  embarked  from  Trieste  or  Hamburg.  Uncle  Sam  must  get  along 
without  this  particular  bit  of  information,3  but  while  you  are  making  things  happen, 
do  not  forget  your  clues.  You  must  know  if  Peter  Novak  has  any  relatives  here  or 
whether  he  belongs  to  any  church  or  fraternal  order.  And  once  poor  Peter  is  pro¬ 
vided  for  today,  in  a  hospital  if  he  will  go  or  at  home  if  he  will  not — he  is  too  ill  to 
be  argued  with — and  you  have  these  clues  for  the  work  that  ought  to  be  done  on 
the  case  tomorrow,  you  will  be  justified  in  going  on  to  your  next  interview. 

Another  story  illustrates  this  matter  of  clues.  .  .  .  The  police  had  tele¬ 

phoned  a  case  of  destitution.  Police  cases  are  always  said  to  be  destitute,  but  as 
soon  as  the  street  and  number  were  given  the  district  worker  knew  that  she  should 
find  some  sickening  form  of  human  suffering.  The  house  was  a  rear  tenement  con¬ 
taining  three  apartments  of  two  rooms  each.  One  of  the  three  she  knew  as  a  dis¬ 
reputable  resort;  in  another  three  children  had  been  ill  with  diphtheria  the  summer 
before;  and  in  the  third  two  consumptives  had  lived  and  died  in  succession.  In 
these  rooms  she  found  a  young  man,  scarcely  more  than  a  boy,  in  the  last  stages  of 
consumption.  He  was  in  a  sullen  state  of  despair  and  weakness  and  would  not  talk. 
He  had  no  people,  he  said — a  brother  somewhere  but  he  did  not  know  where  he 
was.  He  had  no  friends  and  no  one  to  care  about  him.  He  had  made  his  bed  and 
would  lie  in  it. 

Just  here  nine  charity  workers  out  of  ten,  perhaps,  would  have  hurried  away, 
after  seeing  that  food  was  provided  for  the  present  need,  to  send  a  doctor  and  the 
district  nurse,. and  to  order  milk  and  eggs  to  be  sent  to  the  poor  fellow  every  day 

1  See  p.  115. 

2  In  one  of  the  short,  unpublished  papers  referred  to  in  the  Preface. 

3  This  refers  to  the  preparation  of  schedules  for  a  Federal  Immigration  Com¬ 
mission. 


SOCIAL  DIAGNOSIS 


until  he  died.  This  particular  charity  worker  did  nothing  of  the  kind.  It  was 
growing  late  and  she  had  several  other  visits  to  make,  but  how  could  she  leave  this 
poor  fellow  with  no  knowledge  of  him  but  his  terrible  present?  Even  in  the  midst 
of  filth  and  the  ravages  of  disease  she  could  discern  that  somewhere  in  the  past 
which  he  refused  to  disclose  he  had  known  the  comforts  of  a  good  home.  This 
was  a  case  for  slow  persistence  and  searching  question;  the  social  surgeon  must  not 
falter.  At  last  the  name  of  a  former  employer  slipped  out.  The  young  man  learned 
his  trade  there.  Good!  That  former  employer  carried  on  a  wellknown  business 
and  would  know  the  youth  without  doubt.  Forty-eight  hours  after  that  interview, 
the  sick  boy  was  under  his  father’s  roof.  His  parents  were  respectable,  well-to-do 
people,  who  had  tried  to  bring  up  their  son  in  the  right  way.  He  had  fallen  into 
bad  company  and  evil  ways,  and  two  years  before  had  left  home  in  a  violent  passion 
after  some  of  his  wrong-doing  had  been  discovered.  Lately,  his  people  had  heard  a 
vague  rumor  that  he  was  ill  and  had  telephoned  to  the  different  hospitals  in  the  city, 
but  had  given  him  up  for  lost.  When  last  seen  by  his  interviewer,  he  had  been  given 
the  best  room  in  his  father’s  house,  a  room  with  the  sun  in  it  all  day;  his  people 
were  giving  him  all  the  milk  and  eggs  that  he  needed  and  would  be  glad  to  have  the 
nurse  call.  Surely  it  was  worth  while  to  take  time  for  such  a  result.  .  .  .  These 

instances  are  mentioned  because  emergency  interviews  are  the  ones  which  we  are 
most  apt  to  bungle — as  interviews.  We  do  the  right  thing  for  the  emergency,  but 
too  frequently  we  do  not  discover  the  clue  that  will  lead  to  our  case’s  becoming 
something  more  than  an  emergency  case. 

An  agent  of  an  S.  P.  C.  C.  describes  a  visit  to  a  home  for  the  purpose  of  conduct¬ 
ing  a  First  Interview  with  the  mother  of  the  family.  When  she  arrived  at  the  house 
there  was  no  one  to  be  seen,  but  hearing  voices,  she  walked  through  the  kitchen  to 
the  door  of  the  next  room,  where  she  saw  two  women  caring  for  a  young  girl  sick  in 
bed.  She  asked,  "Is  someone  sick  here?”  The  mother  replied,  “Yes,  Alice.” 
Without  another  question,  and  behaving  as  though  she  had  known  Alice  all  her  life, 
the  agent  soon  had  a  physician  in  to  examine  the  girl,  an  ambulance  there  to  take 
her  to  the  hospital,  and  an  operation  performed  for  appendicitis — all  this  without 
a  word  of  protest  from  the  mother  or  a  single  inquiry  as  to  who  she  was  or  how  she 
had  come. 

SUMMARY  OF  THIS  CHAPTER 

i.  There  are  many  circumstances  that  may  modify  the  method  of  a  First  Inter¬ 
view.  Among  these  are 

(a)  The  nature  of  the  task  about  to  be  undertaken,  whether  probation  work, 
family  work,  protection  from  cruelty,  etc. 

(b)  The  origin  of  the  application  or  request  for  service;  whether  from  an  agency 
or  individual  already  interested,  or  from  an  applicant  on  his  own  behalf. 

(c)  The  place  of  the  interview,  whether  in  the  client’s  own  home  or  at  the 
social  agency’s  office. 

(d)  The  recorded  experience  available.  Any  possible  previous  rt  v-)  in  the 
agency’s  files  concerning  either  the  person  applying  or  others  of  his  famil)  iearcb 
should  be  made  for  such  a  record  before  the  First  Interview  and  again  after  is  ck  .  . .) 

!32 


THE  FIRST  INTERVIEW 


Any  possible  previous  records  of  other  social  organizations  that  show  relations  with 
the  person  applying.  (Where  there  is  a  confidential  exchange,  it  should  be  consulted 
for  this  information  both  before  the  First  Interview  and  after.) 

2.  The  First  Interview  should  (a)  give  a  fair  and  patient  hearing;  (b)  seek  to 
establish  a  good  mutual  understanding;  (c)  aim  to  secure  clues  to  further  sources 
of  insight  and  co-operation;  (d)  develop  self-help  and  self-reliance  within  the  client’s 
range  of  endeavor. 

The  interview  must  not  be  hurried,  therefore;  it  must  be  held  in  privacy,  and 
with  every  consideration  for  the  feelings  of  the  one  interviewed,  though  always  with 
a  definite  goal  in  view. 

3.  Many  questions  have  been  answered  before  they  are  asked;  these  need  not 
be  asked  by  a  good  listener.  Necessary  questions  should  be  so  framed  as  to  make 
truth-telling  easy.  Questions  that  can  be  better  answered  by  someone  else  are  not 
necessary  ones. 

4.  The  clues  most  frequently  needed  from  the  initial  interview  are  (a)  relatives, 
(b)  doctors  and  health  agencies,  (c)  schools,  (d)  employers,  past  and  present,  (e) 
previous  residences  and  neighborhoods. 

5.  The  client’s  own  hopes,  plans,  and  attitude  toward  life  are  more  important 
than  any  single  item  of  information. 

6.  Note-taking  during  the  interview  is  often  not  wise,  though  this  depends  upon 
the  nature  of  the  request  and  upon  the  place  of  the  interview. 

7.  Advice  and  promises  should  be  given  sparingly  until  there  has  been  time  to 
know  more  and  to  plan  more  thoughtfully. 

8.  The  last  five  or  ten  minutes  of  the  interview  should  emphasize  the  inter¬ 
viewer’s  desire  to  be  helpful,  and  prepare  the  way  still  further  for  future  intercourse. 

9.  Emergency  interviews  call  for  special  skill,  because,  though  time  presses, 
certain  essential  clues  are  more  important  than  usual. 


133 


CHAPTER  VII 


THE  FAMILY  GROUP 


DISCUSSION  of  theories  of  society  and  of  the  organiza¬ 


tion  of  the  family  is  no  part  of  the  plan  of  this  book.  The 


^  ^  social  worker's  convictions  about  the  family,  even  when 

they  are  those  of  the  extreme  feminist  Left  or  of  the  extreme  re¬ 
actionary  Right,  will  be  clarified  and  to  some  extent  modified, 
however,  by  a  type  of  case  work  which  follows  wherever  the  facts 
and  the  best  interests  of  his  clients  lead.  It  is  true  that  his  theories 
will  influence  his  work,  but  more  and  more,  if  he  is  in  earnest,  will 
his  work  influence  his  theories.  Our  only  concern  here  is  with 
family  life  as  a  present-day  fact. 

It  is  a  sobering  thought  that  the  social  worker's  power  of  in¬ 
fluence  may  extend,  through  his  daily  acts,  to  many  whom  he  has 
never  seen  and  never,  even  for  a  moment,  had  in  mind.  This  is 
peculiarly  true  of  all  the  members  who  are  unknown  to  him  in  the 
Family  Groups1  of  his  clients.  For  better  or  worse  he  influences 
them  and  they,  in  turn,  help  or  hinder  the  achievement  of  the  ends 
that  he  has  in  view. 

As  society  is  now  organized,  we  can  neither  doctor  people  nor 
educate  them,  launch  them  into  industry  nor  rescue  them  from  long 
dependence,  and  do  these  things  in  a  truly  social  way  without  tak¬ 
ing  their  families  into  account.  Even  if  our  measure  were  the 
welfare  of  the  individual  solely,  we  should  find  that  ^he  good  re¬ 
sults  of  individual  treatment  crumble  away,  often,  because  the 
case  worker  has  been  ignorant  of  his  client's  family  history.  Sud¬ 
denly  and  usually  too  late,  the  social  practitioner  is  made  aware  of 
this,  when  tendencies  that  have  long  been  hidden  become  opera¬ 
tive.  The  following  statement  illustrates  the  diagnostic  impor¬ 
tance  of  family  background.  It  appears  in  a  singularly  frank  and 

1  The  term  Family  Group  as  used  in  this  chapter  and  later  includes  all  who  share 
a  common  table,  though  the  parents  and  children — usually  the  most  important 
members  of  the  group — will  receive  most  attention  here. 


134 


THE  FAMILY  GROUP 


intelligent  study  of  a  child-placing  agency's  work,  made  by  the 
agency  itself : 

On  the  reception-inquiry  side  we  found  that  we  had  accepted  children  in  very 
critical  need  of  special  kinds  of  care  without  knowing  the  particular  defects  in 
heredity  which  made  certain  of  our  treatments  unwise  or  dangerous.  For  example, 
we  had  one  exceedingly  nervous  girl  in  charge  for  several  years  before  we  discovered 
that  she  had  an  insane  grandmother;  that  her  father  and  mother  had  both  died  in¬ 
sane,  and  that  this  strain  of  insanity  explained  certain  characteristics  which  we  had 
most  incorrectly  interpreted.  We  also  discovered  during  the  study  that  another 
none  too  robust  girl  suffering  with  congenital  syphilis  had  three  generations  of 
ancestors  with  almshouse  records,  a  grandmother  who  was  insane**and  at  one  time 
a  state  ward,  and  a  mother  who  was  both  epileptic  and  an  imbecile.  The  need  of  a 
most  protective  kind  of  care,  expressed  in  quietness,  careful  medical  supervision, 
and  freedom  from  strain  were  indicated  as  clear  essentials;  yet  in  one  instance  we 
were  planning  to  put  the  child  under  very  great  discipline  because  she  seemed  stub¬ 
born. 

After  giving  a  number  of  instances,  of  the  same  general  tenor,  the  agency  adds: 
In  no  instance  would  it  have  been  easy  for  us  to  have  secured  all  this  information 
when  the  children  were  first  received;  but  that  we  learned  much  of  it  years  after¬ 
wards  is  proof  that  in  some  cases  we  could,  and  should,  have  had  it  from  the  start.1 

The  foregoing  experience  was  that  of  a  placing-out  agency;  lest 
it  be  inferred  that  institutional  work  for  children  can  more  safely 
ignore  home  conditions  than  can  placing-out,  the  story  of  Pitts¬ 
burgh's  institutions,  as  told  by  Miss  Florence  L.  Lattimore,  should 
be  noted  also.  In  her  recapitulation  she  says: 

Every  time  an  institution  had  allowed  a  family  to  break  up  or  sink,  without 
seeing  that  intelligent  effort  was  made  to  save  it  (if  it  were  not  already  too  late), 
and  every  time  it  had  returned  a  child  to  a  home  that  was  unfit,  it  had  strengthened 
the  forces  that  had  created  the  application.  Every  time  it  had  placed  out  a  child 
without  adequate  home  study  of  the  family  to  which  he  went  and  without  ade¬ 
quately  supervising  him  after  placement,  it  had  run  the  risk  of  canceling  all  its 
previous  efforts  to  help  him.  Many  of  the  children  were  like  dropped  stitches  in  a 
knitted  garment,  and  the  whole  family  was  likely  to  unravel  unless  the  trouble  was 
caught  up  at  the  start.  It  was  often  a  children’s  institution  which  received  the 
first  hint  of  a  situation  which,  if  unheeded,  later  on  involved  several  households.2 

A  report  from  a  hospital  social  service  department  describes  a  first  interview  held 
with  a  sickly  wife  at  work  over  the  washtub.  She  explains  that  her  husband  has 
been  living  with  his  mother  ever  since  he  lost  his  work,  and  the  interviewer  at  once 
promises  to  secure  extra  milk  for  wife  and  children,  without  attempting  to  see  the 

1  Ruth  W.  Lawton  and  J.  Prentice  Murphy  in  National  Conference  of  Charities 
and  Correction  Proceedings  for  1915  (Baltimore),  p.  167. 

2  “  Pittsburgh  as  a  Foster  Mother”  in  The  Pittsburgh  District,  p.  427. 

135 


SOCIAL  DIAGNOSIS 


man.  As  health  workers  carry  their  services  of  many  kinds  more  and  more  into 
the  home,  it  becomes  increasingly  important  that  they  learn  to  think  of  the  family 
as  a  whole.  Unless  they  do,  their  service  will  be  short-circuited — an  unrelated  and 
unrelatable  specialty.1 

The  need  of  keeping  the  family  in  mind  extends  beyond  the 
period  of  diagnosis,  of  course.  “I  will  return,”  says  Dubois,  “to 
this  necessity  of  not  confining  one’s  therapeutic  effort  to  the  patients 
alone,  but  extending  it  to  those  who  live  with  them.  This  is  often 
the  one  way  to  obtain  complete  and  lasting  results.”2 

As  stated  in  the  preceding  chapter,  the  first  interview  is  often 
held  in  the  client’s  home  and  with  members  of  his  family  present. 
To  this  extent  the  two  separate  processes  of  making  our  first  con¬ 
tacts  with  the  client  and  with  his  family  can  and  often  do  overlap. 
It  is  impossible  to  lay  down  any  hard  and  fast  rule  about  their 
combination  or  separation.  For  the  highly  individualized  diag¬ 
nosis  and  treatment  needed  for  a  delinquent,  however,  it  is  evident 
that  such  conditions  of  privacy  as  Dr.  Healy  describes3  are  neces¬ 
sary  in  the  first  interview.  No  third  person  must  be  present, 
nothing  must  distract  the  client’s  attention  or  interrupt  the  de¬ 
velopment  of  his  story.  Even  then,  not  all  will  be  revealed  at 
this  one  time  or  in  this  one  way,  as  Dr.  Healy  recognizes  more  fully 
than  anyone  who  has  yet  written  upon  his  subject.4  “  It  is  in  each 
man’s  social  relations  that  his  mental  history  is  mainly  written”5 

1  “To  keep  a  promising  boy  at  school  after  the  legal  working  age,  to  provide 
costly  treatment  for  a  sick  girl,  to  force  a  well-to-do  relative  to  support  his  kinsfolk, 
to  punish  a  deserting  husband,  to  withdraw  wage-earners  from  unwholesome  work — 
may  each  represent  to  some  specialist  the  supreme  duty  of  organized  social  work  in 
one  family  where  each  of  these  needs  is  apparent.  It  may  not  be  possible  to 
meet  them  all  at  once,  and  it  may  be  that  some  cannot  be  met  at  all  without  sacri¬ 
ficing  other  important  factors  in  the  family  welfare.  It  is  just  as  true  in  the  econ¬ 
omy  of  the  family  as  it  is  in  the  economy  of  society  at  large  that  the  interests  of  the 
individual — for  his  own  good  or  for  society’s — must  be  adjusted  to  the  interests 
of  the  whole.  The  recognition  of  this  by  specialists  is  necessary  if  we  are  to  avoid 
danger  in  social  treatment.  Here  evidently  clear  thinking  and  honest  discussion 
are  called  for.  This  conflict  can  only  be  avoided  if  we  are  willing  to  study  the  whole 
problem  of  family  responsibility.  Prejudice  in  favor  of  one’s  own  specialty  must 
be  abandoned  and  the  matter  decided  in  each  individual  case  disinterestedly  by 
the  agencies  concerned,  on  the  basis  of  all  the  facts  obtainable.” — Porter  R.  Lee, 
in  Proceedings  of  National  Conference  of  Charities  and  Correction  for  1914  (Mem¬ 
phis),  p.  97. 

2  Psychic  Treatment  of  Nervous  Disorders,  p.  44.  3  Quoted  on  p.  129. 

4  “We  have  been  surprised  to  find  that  one  of  the  most  particular  portions  of  the 
work  was  the  interviewing  of  the  relatives.” — The  Individual  Delinquent,  p.  46. 

6  Dr.  James  Jackson  Putnam.  See  motto  of  this  volume. 

136 


THE  FAMILY  GROUP 


and  no  attempt  to  help  a  human  being  which  involves  influencing 
his  mind  in  any  degree  whatsoever  is  likely  to  succeed  without  a 
knowledge  of  the  Family  Group  of  which  he  is  a  part,  or  without 
definite  co-operation  with  that  group.  In  some  forms  of  social 
work,  notably  family  rebuilding,  a  client’s  social  relations  are  so 
likely  to  be  all  important  that  family  case  workers  welcome  the 
opportunity  to  see  at  the  very  beginning  of  intercourse  several 
of  the  members  of  the  family  assembled  in  their  own  home  environ¬ 
ment,  acting  and  reacting  upon  one  another,  each  taking  a  share 
in  the  development  of  the  client’s  story,  each  revealing  in  ways 
other  than  words  social  facts  of  real  significance.  As  regards 
group  versus  individual,  home  versus  office  interviews,  the  tendency 
has  been  for  each  form  of  social  work  to  establish  one  unvarying 
procedure.  Better  results  could  be  had,  probably,  from  a  dis¬ 
criminating  use  of  all  the  different  methods  of  approach. 

In  any  case,  it  is  evident  that  the  relation  a  diagnostician  has 
with  his  client’s  immediate  Family  Group  is  somewhat  different 
from  his  relation  with  the  sources  of  evidence  and  service  which 
lie  outside  the  family.  A  former  creditor  or  the  custodian  of  a 
medical  or  a  birth  record  may  give  him  information  of  the  first 
importance,  and  never  reappear  thereafter  in  the  treatment  which 
is  to  follow;  whereas  the  co-operation  of  the  immediate  family 
may  have  to  be  sought  again  and  again  at  successive  stages  of  the 
treatment,  even  when  the  social  problem  revealed  is  an  individual 
one.  For  instance,  take  the  peculiarly  individual  problem  pre¬ 
sented  by  pathological  lying,  a  disease  in  which  the  affected  person 
has  “very  little  sympathy  for  the  concern  of  others,  and,  indeed, 
remarkably  little  apperception  of  the  opinions  of  others.”  Yet 
Dr.  Healy  emphasizes  for  its  treatment  the  need  of  adequate  co¬ 
operation  in  the  home  or  from  someone  outside  with  influence  over 
the  individual.1 


I.  THE  FAMILY  AS  A  WHOLE 

The  remaining  pages  of  this  chapter  must  be  taken  as  belonging 
with  certain  of  the  questionnaires  in  Part  III  and  with  several 
bf  the  chapters  on  outside  sources.  The  health  of  the  family, 
its  educational  opportunities,  the  occupations  of  its  members, 

1  Pathological  Lying,  Accusation,  and  Swindling,  pp.  253  and  272. 

137 


SOCIAL  DIAGNOSIS 


are  all  matters  of  fundamental  importance,  but  it  has  seemed  more 
convenient  to  treat  each  of  them  in  a  separate  chapter  in  con¬ 
nection  with  sources.1  As  regards  the  relation  of  the  family 
make-up  to  certain  outstanding  social  disabilities,  such  as  recent 
immigration,  desertion,  widowhood,  inebriety,  and  child  neglect, 
these  matters  are  emphasized  in  the  questionnaires  in  Part  III 
devoted  to  the  particular  disabilities  named.  The  less  formal  dis¬ 
cussion  here  of  the  family  as  a  whole,  of  the  husband  and  father, 
wife  and  mother,  children,  and  other  members  of  the  household, 
may  be  taken  as  introductory  to  the  questions  relating  to  the  fam¬ 
ily  in  these  questionnaires. 

1.  The  Main  Drift  of  the  Family  Life.  One  who  has  learned, 
in  the  details  of  a  first  interview,  to  keep  the  “  combined  physical 
and  moral  qualities,”  the  whole  man,  in  view,  will  appreciate  the 
importance  of  applying  this  same  view  to  the  family.  The  family 
life  has  a  history  of  its  own.  It  is  not  what  it  happens  to  be  at 
some  particular  moment  or  “  in  reference  to  some  particular  act/' 
but  it  is  what  it  is  “on  the  whole.”2  What  will  help  to  reveal  this 
trend?  What  external  circumstances  over  which  the  family  had 
no  apparent  control,  and  what  characteristics  of  its  members — 
physical,  mental,  temperamental — seem  to  have  determined  the 
main  drift? 

Revealing  things  are  any  signs  of  affection  and  consideration  in 
the  relations  of  its  members  to  one  another.  Again,  what  does  the 
family  admire?  What  are  its  hopes  and  ambitions?  Has  it  shown 
initiative  at  any  time?  What  part  has  religion  in  the  home  life? 
What  ability  has  the  home  developed  in  its  members  to  resist 
temptation?  What  do  they  do  with  their  leisure  time?  Do  they 
seek  amusement  together  or  apart?  What  were  the  two  homes 
like  from  which  the  parents  came  to  make  this  third  one?  A 
visit  or  two  will  not  answer  all  these  questions ;  the  answer  to  some 
will  come  from  outside  sources  and  to  others  only  gradually,  but 
the  worker  who  ignores  these  aspects  and  is  entirely  preoccupied 
with  names  and  ages,  number  of  rooms  occupied,  sanitation,  in- 

1  See  Chapters  X,  Medical  Sources,  XI,  Schools  as  Sources,  and  XII,  Employers 
and  Other  Work  Sources. 

2  Jowett,  Benjamin:  Sermons,  Biographical  and  Miscellaneous,  p.  8o.  Ed.  by 
W.  H.  Fremantle.  New  York,  E.  P.  Dutton  and  Co.,  1899. 

138 


THE  FAMILY  GROUP 


come  and  outgo,  school  attendance,  etc.,  will  never  win  lasting 
results  in  social  case  work. 

Nothing  can  interfere  more  effectually  with  a  large  and  well 
balanced  view  than  preoccupation  with  some  picturesque  minor 
incident.  The  writer  remembers  a  family  history  of  years  ago 
which  was  made  more  painful  than  it  need  have  been  by  a  series  of 
social  treatments  which  lost  all  grasp  of  the  main  issues  involved. 
These  failures  were  due  to  the  striking  circumstance  that  the 
father  of  the  family,  which  lived  in  great  squalor,  had  named  his 
youngest  child  Thomas  Carlyle.  The  literary  members  of  several 
charities  were  unduly  impressed  by  this  interesting  incident  in  the 
life  of  a  gambler. 

2.  The  United  and  the  Unstable  Family.  There  is  a  distinction, 
made  first  by  Le  Play,  which  will  help  us  to  a  better  conception 
of  the  family  as  a  whole.  With  reference  to  their  power  of  co¬ 
hesion,  we  shall  find  that  families  range  themselves  along  a  scale, 
with  the  degenerate  family  at  one  end  and  the  best  type  of  united 
family  at  the  other.  Whatever  eccentricities  a  family  may  de¬ 
velop,  the  trait  of  family  solidarity,  of  hanging  together  through 
thick  and  thin,  is  an  asset  for  the  social  worker,  and  one  that 
he  should  use  to  the  uttermost.  “  It  is  not  merely  a  question/' 
says  Mrs.  Bosanquet  (whose  book,  The  Family,  more  especially 
Part  II,  should  be  known  to  every  case  worker),  “of  how  long  the 
members  of  a  family  continue  to  live  together  in  one  house; 
superficially  the  two  types  may  be  much  alike  in  this  respect.  It 
is  one  of  the  proofs  of  the  strength  of  the  modern  family  that  it  is 
able  to  send  its  sons  and  daughters  far  over  the  face  of  the  earth 
without  in  the  least  impairing  the  bond  which  unites  them;  while 
it  is  one  of  the  proofs  of  the  weakness  of  the  degenerate  family  that 
there  is  no  bond  to  hold  them  together  at  all,  or  a  bond  so  slender 
that  removal  into  the  next  street  is  enough  to  sever  it.  The  real 
nature  of  the  distinction  can  only  become  clear  as  we  study  the 
characteristics  of  the  modern  family  at  its  best."1  These  charac¬ 
teristics  are  admirably  developed  in  the  second  half  of  Mrs.  Bosan- 
quet’s  book,  but  American  readers  will  have  to  bear  in  mind  that  it 
records  the  traits  of  a  homogeneous  population,  of  one  that  has 
been  exposed  to  no  sudden  changes  of  environment,  and  no  over- 

1The  Family,  p.  193. 

139 


SOCIAL  DIAGNOSIS 


whelming  temptation  of  newly  found  freedom.  We  find  in  this 
country  many  signs  of  disintegration  due  to  these  surface  causes, 
even  in  families  in  which  there  is,  at  bottom,  strong  family  feeling, 
and  we  cannot  understand  the  evils  that  beset  them  unless  we  are 
at  some  pains  to  study  the  racial  and  national  traditions  that  cling 
so  tenaciously  around  certain  of  the  foreign  Family  Groups  exposed 
to  American  ideas,  and  that  crumble  away  too  quickly  from  cer¬ 
tain  others.1 

Whenever  serious  estrangement  occurs  between  husband  and 
wife,  or  parent  and  child,  the  first  thing  to  study  is  the  differences, 
if  any,  in  racial,  national,  and  community  background,  with  the 
resulting  differences  of  custom,  convention,  religion,  and  education. 
Next  to  disparity  of  age,  to  marriage  or  remarriage  for  economic 
reasons,  and  the  interference  of  relatives,  differences  of  nationality, 
race,  or  religion  are  the  most  fruitful  causes  of  trouble  between 
man  and  wife,  and  varying  degrees  of  adjustment  to  the  new  world 
environment  are  fruitful  causes  of  trouble  between  parent  and  child. 

It  is  difficult  to  illustrate  briefly  what  is  meant  by  dealing  with 
the  family  as  a  whole  with  a  clear  conception  of  the  main  drift  of 
the  family  life  always  in  mind,  but  the  following  criticism  of  a 
case  record  of  a  deserter  and  his  family  will  give  some  conception 
of  the  point  of  view: 

The  record  comes  from  a  charity  organization  society,  and  describes  the  efforts 
of  the  society  to  find  Mr.  Angus  Doyle,  a  Scotch  ship  fitter  who  had  left  his  Scotch- 
American  wife,  Kate,  and  four  children,  the  oldest  a  girl  of  fifteen,  going  off  this 
time,  as  was  usual  with  him,  when  another  baby  was  expected.  He  was  a  good 
workman,  but  a  hard  drinker  and  abusive.  By  energetic  correspondence  and  the 
aid  of  a  similar  society  in  another  state,  Doyle  was  found,  his  employers  were  in¬ 
terested,  and  the  man  was  induced  to  send  $7.00  a  week  regularly  to  his  family. 
After  the  fifth  child  was  born,  he  came  home  and  was  overheard  telling  one  of  his 
mates  that  it  made  no  difference  where  a  man  went  in  this  country  now,  he  was 
found  out  and  made  to  support  his  family.  / 

So  far  so  good,  and  the  critic  of  the  record  comments  upon  the  good  work  of  both 
societies  in  influencing  the  man  through  his  employer.  Sometimes  such  an  ap¬ 
proach  simply  means  that  the  man  drops  his  work  and  goes  elsewhere;  but  there  are 
not  many  shipyards  in  the  United  States,  the  wife  was  in  no  physical  condition  at 
the  time  to  push  through  a  court  prosecution,  and  the  societies  probably  reasoned 
that  their  best  chance  was  to  see  the  man  in  the  presence  of  his  superintendent,  and 
appeal  to  him  to  make  weekly  payments. 

1  Some  of  these  traditions  are  suggested  in  the  introduction  to  the  Immigrant 
Family  Questionnaire,  p.  384. 

I40 


THE  FAMILY  GROUP 


Returning  to  the  family  history  (the  criticism  continues),  we  find  three  genera¬ 
tions  on  the  mother’s  side  in  one  city  neighborhood — a  neighborhood  of  varied  in¬ 
dustrial  opportunities  evidently.  We  have  the  chance  therefore,  if  we  choose  to 
take  it,  though  the  record  does  not  help  us  very  much,  to  fill  in  a  background  for 
Mrs.  Doyle’s  mother,  Mrs.  Clayton,  for  Mrs.  Doyle  herself,  and  for  her  fifteen-year- 
old  daughter,  Margaret  Doyle. 

1  am  trying  to  suggest  many  of  the  possibilities  instead  of  just  a  few  of  them,  but 
it  will  be  evident  that  some,  at  least,  have  a  direct  bearing  upon  further  treatment, 
if  there  is  to  be  any.  What  sort  of  homemaker  was  Mrs.  Clayton?  According  to 
a  physician  who  “knows  the  whole  family  connection,”  she  is  a  “rum  soak”;  ac¬ 
cording  to  Doyle’s  sister  (who  herself  “has  an  attractive  home”  and  “seems  very 
placid  and  sensible”)  she  “is  not  the  right  kind  of  woman  and  easily  leads  Kate 
[Mrs.  Doyle]  astray.”  This  same  sister  relates  that  the  Doyles  married  when  Kate 
was  sixteen  and  Angus  eighteen  and  that  "they  have  never  agreed”;  that  Mrs 
Doyle  is  a  good  mother,  manages  her  children  well,  and  is  very  clean,  but  that  on 
the  other  hand,  while  she  is  not  a  drunkard,  she  sometimes  drinks — a  statement 
corroborated,  as  to  the  past,  by  the  physician  already  quoted  regarding  Mrs.  Clay¬ 
ton.  The  sister’s  further  statement  that  Mrs.  Doyle  had  “deviled”  her  husband 
into  leaving  and  that  if  she  would  “hold  her  tongue”  she  ought  to  be  able  to  “jolly 
him  along”  and  keep  a  nice  home  has  little  evidential  value,  but  does  suggest  that 
Mrs.  Doyle  may  be  ill  tempered  or  given  to  nagging.  Altogether,  there  would 
seem  to  be  some  fault  on  both  sides,  though  scant  basis  is  revealed  for  Angus 
Doyle’s  statement  that  “his  wife  drank,  neglected  her  home,  their  children,  and  his 
meals”;  according  to  the  visitor,  the  “home  is  neatly  and  attractively  kept,  chil¬ 
dren  well  mannered,  woman  certainly  not  drinking  now.” 

As  to  the  husband,  we  have  little  evidence  that  is  favorable.  His  employers  had 
put  up  with  his  “periodical  sprees”  because  he  was  an  excellent  mechanic;  and, 
knowing  nothing  to  the  contrary,  his  fellow  workers  believed  his  statement  that  he 
“had  a  dreadful  life  with  his  wife.”  According  to  the  physician  already  quoted, 
he  is  “utterly  worthless;  undoubtedly  a  good  worker,  but  drinks  hard  and  cares 
for  no  one  but  himself.”  His  sister  did  not  shield  him  as  to  the  drink;  apparently 
the  only  virtue  that  she  imputed  to  him  was  that  he  was  “not  lazy.” 

Here,  then,  is  a  situation  in  which  there  are  elements,  behind  the  obvious  fact 
of  desertion  and  non-support,  which  render  the  return  of  the  deserter  far  from  a 
final  solution  of  the  difficulty.  He  has  learned  a  lesson,  doubtless,  from  his  latest 
experience;  perhaps  it  may  restrain  him  when  next  the  impulse  to  shake  off  family 
responsibilities  seizes  him,  though  of  this  we  can  be  by  no  means  sure;  but  so  long 
as  he  continues  to  be  a  periodic  drinker  and  abusive,  so  long  as  he  and  his  wife  are 
unable  to  live  in  peace,  it  can  hardly  be  said  that  the  family  problem  is  satisfactorily 
solved. 

With  the  scanty  array  of  facts  at  our  disposal  it  is  impossible  to  say  what  the 
next  move  should  have  been,  after  the  deserter  had  been  found  and  a  regular  in¬ 
come  from  him  insured.  It  would  seem  that  at  this  point  time  might  have  been 
taken  to  build  in  a  background — to  learn  something  of  Doyle’s  boyhood,  his  home 
training,  schooling,  early  work  history.  Inquiry  of  the  sister  might  reveal,  for  ex- 


SOCIAL  DIAGNOSIS 


ample,  that  he  had  been  a  trial  from  his  earliest  years  to  devoted  parents  who  had 
set  him  an  excellent  example — an  habitual  truant  and  runaway,  let  us  say,  who  later 
had  refused  to  turn  in  his  earnings.  Or  again,  it  might  appear  that  his  record  as 
school  boy,  son,  and  young  worker  had  been  excellent,  and  that  his  delinquencies 
had  not  begun  till  some  years  after  his  marriage.  It  is  evident  that  there  would  be 
greater  hope  in  the  latter  case  than  in  the  former  of  studying  out,  with  Mrs.  Doyle’s 
aid,  the  underlying  causes  of  the  difficulty  and  finding  a  remedy.  In  the  same  way, 
coming  to  more  recent  history,  it  might  be  useful  to  know  the  effect  of  dull  times  in 
the  shipbuilding  trade  upon  Doyle’s  habits  and  movements.  Was  he  at  home  or 
away,  drinking  or  sober,  during  the  panic  of  1907-08?  Is  his  work  seasonal? 
What  is  his  state  of  health?  Has  he  ever  been  arrested?  Is  there  any  court  record? 
Are  the  children  fond  of  him? 

On  the  industrial  side,  had  Mrs.  Doyle,  who  worked  as  a  buffer  in  the  metal 
works,  been  so  engaged  when  her  husband  was  at  home  and  working,  or  had  she 
worked  in  his  absence  only?  In  either  case,  what  effect  had  her  ability  to  earn  and 
to  support  the  family  had  upon  him?  But  for  her  condition,  she  would  have  been 
earning  $2.25  a  day  at  the  buffing  wheels  when  the  society  visited  her.  Is  this 
healthful  work  for  the  mother  of  a  family?  Is  it  related  in  any  way  to  the  fact  of 
her  drinking?  How  did  the  children  fare  under  Mrs.  Clayton’s  care  in  their  mother’s 
absence?  What  about  Margaret’s  work  in  the  hosiery  mill — are  conditions  favor¬ 
able  to  health  and  future  prospects  fair? 

The  society  was  quite  right  to  concentrate,  as  regards  treatment,  upon  the  de¬ 
sertion  issue  first;  to  find  the  man,  that  is,  and  put  upon  him  the  financial  burden  of 
his  family.  But,  having  gained  an  excellent  footing  with  Kate  Doyle  by  so  doing, 
and  the  whole  social  and  industrial  environment  that  had  been  too  much  for  the 
family  in  the  past  remaining  what  it  had  been,  was  the  chance  to  readjust  their 
relation  taken  full  advantage  of?  Their  earnings  were  larger  than  usual  upon 
the  last  visit — a  fact  which  should  have  made  constructive  work  easier — and  the 
drink,  the  instability,  the  likelihood  of  another  family  breakdown  should  have  been 
dealt  with  one  by  one. 

Perhaps  my  criticism  may  seem  to  overemphasize  a  string  of  items,  but  all  of 
them  lead  to  one  point;  namely,  that  to  organize  the  social  services  of  a  community 
in  any  vital  sense,  we  must  all  be  working  out,  in  at  least  a  minority  of  the  families 
that  come  under  our  care,  the  synthetic  relation  of  the  industrial,  physical,  moral, 
and. social  facts  which  affect  their  welf mreTTn  ot Her  words,  what  might  have  been 
a  good  beginning  with  the  Doyles  was  mistaken  for  a  good  ending.  From  the  very 
first  interview  with  Mrs.  Doyle  the  possibility  of  this  wider  program  might  have 
been  kept  in  view  and  might  have  shaped  the  diagnosis. 

Even  where  background  is  not  kept  in  mind  from  the  beginning, 
it  is  possible  to  recover  the  ground  that  has  been  lost  and  achieve 
synthetic  results  later  on,  though  it  is  not  so  easy  to  do  so.  The 
Braucher  case,  a  summary  of  which  is  given  in  Chapter  IX,  Rela¬ 
tives  as  Sources,1  illustrates  this  possibility. 

1  See  p.  188  sq. 

142 


THE  FAMILY  GROUP 


II.  THE  HUSBAND  AND  FATHER 

1.  The  Man  Should  Be  Seen.  Husband  and  wife  are  not  of  the 
same  blood,  be  it  remembered.  They  have  a  past  in  common,  but 
each  has  had  an  earlier  past  apart,  and,  since  in  many  forms  of 
social  work  we  see  much  of  the  wife  and  children  and  little  or 
nothing  of  the  husband  and  father,  it  is  necessary  deliberately  to 
keep  him  in  mind,  Faulty  methods  of  social  work  may  have  led 
him  to  think  that  his  wife  should  do  all  the  applying  and  explain¬ 
ing,  but  an  understanding  of  the  plans  and  purposes  of  the  man  of 
the  family — his  ambitions  for  his  children  and  for  himself — cannot 
be  had  without  early  personal  contact  with  him.  It  is  safer  and 
it  is  fairer  so,  and  our  later  planning  and  conferring  should  include 
him.  “It  is  our  business  to  see  the  man  in  this  case/'  writes  a 
critic  of  a  family  record.  “  He  is  probably  all  he  is  painted  to  be, 
but  he  has  a  right  to  a  hearing/' 

At  one  charity  office,  the  man  of  the  family  apologized  for  not  sending  his  wife, 
explaining  that  she  was  too  sick  to  come  that  day,  or  else  she  would  have  applied. 
He  was  told  that  the  secretary  much  preferred  to  confer  with  him  about  his  family’s 
distress,  because  it  was  his  affair,  as  the  breadwinner,  even  more  than  his  wife’s. 

As  plans  for  various  forms  of  child  welfare  multiply  it  is  more  easy  than  ever  to 
overlook  the  man  of  the  family.  “Many  probation  officers  fail  to  make  the  ac¬ 
quaintance  of  the  fathers  of  the  children  in  their  care  during  the  whole  period  of 
probation,”  write  Flexner  and  Baldwin.1  “It  is  generally  a  little  difficult  to  get  in 
touch  with  a  father,  but  he  is  often  the  key  to  the  whole  problem.  Probation  officers 
should  make  an  effort  to  have  at  least  an  acquaintance  with  the  father  of  every  child 
in  their  care,  whether  or  not  that  acquaintance  can  be  carefully  followed  up  by  close 
co-operation  with  him.” 

An  S.  P.  C.  C.  worker  in  a  small  town  says  that  she  tries  to  get  all  possible  in¬ 
formation  from  the  family  direct,  seeking  first  the  man’s  story,  then  the  woman’s, 
then  bringing  them  together,  if  possible,  and  getting,  in  this  joint  interview,  a  good 
deal  of  new  light.  She  appeals  to  them  to  be  frank  with  her  in  order  to  avoid 
gossip,  adding,  “You  know  how  the  people  around  here  like  to  talk,  and  it  will  be 
far  better  for  us  to  settle  this  thing  ourselves  if  we  can.” 

2.  Place  of  Interview.  It  is  often  better  to  see  the  two  heads 
of  the  family  separately,  making  a  special  evening  appointment 
at  the  case  worker's  office  or  at  some  other  convenient  place  in 
order  to  do  this.  There  may  be  substantial  like-mindedness  be¬ 
tween  husband  and  wife  and  no  domestic  misunderstandings,  but, 

juvenile  Courts  and  Probation,  p.  136. 

M3 


SOCIAL  DIAGNOSIS 


in  the  joint  interview,  one  naturally  leads  and  the  other  follows, 
so  that  it  is  difficult  to  get  acquainted  with  both. 

To  attempt  to  see  the  man  of  the  family  at  his  work  place,  es¬ 
pecially  if  this  happens  to  be  a  large  concern,  is  unwise,  though 
it  is  sometimes  possible  to  see  him  there  at  the  noon  hour.  His 
employer  objects  to  having  him  called  away  from  his  work,  and  he 
is  not  at  his  ease,  moreover.  One  social  worker  who  attempted 
such  an  interview  with  a  man  who  ran  an  elevator  found  every 
few  sentences  interrupted  by  the  elevator  bell. 

The  head  of  a  department  for  mothers  and  infants  in  a  children’s 
organization,  recognizing  that  it  would  be  a  mistake  to  communi¬ 
cate  with  a  father  through  the  unmarried  mother  of  his  child, 
always  writes  to  the  man,  instead  of  sending  him  a  message. 
She  includes  in  her  letter  the  statement  that  so-and-so  has  been  to 
see  her  and  told  her  something  of  their  situation;  that,  before 
making  any  plan,  she  wants  to  talk  the  matter  over  with  him;  end¬ 
ing  by  saying  that  she  will  gladly  meet  him  at  her  office  at  any 
hour  that  suits  his  convenience.  This  worker  believes  that  men 
prefer  to  discuss  all  matters  of  business  away  from  their  own  homes. 
In  a  given  twelve  months  she  wrote  25  such  letters  to  the  fathers  of 
illegitimate  children.  Ten  called  at  her  office  in  response;  seven 
responded  by  letter  and  four  of  these  were  seen  later,  though  not 
at  the  office;  the  remaining  eight  did  not  reply. 

3.  The  Unmarried  Father.  Efforts,  such  as  the  foregoing,  to 
deal  in  illegitimacy  cases  with  the  father  quite  as  directly  as  with 
the  mother  and  child,  and  to  do  this  out  of  court  in  the  first  in¬ 
stance,  are  further  illustrated  by  the  following  case  notes: 

A  children’s  society  was  puzzled  as  to  whether  it  should  urge  marriage  between 
the  father  and  mother  of  a  small  baby.  A  clergyman  and  other  references  thought 
the  young  fellow  careless  and  self-indulgent,  and  all  the  evidence  seemed  to  be 
against  the  marriage.  Not  quite  satisfied,  however,  the  children’s  worker  decided 
to  try  the  experiment  of  having  the  man  confronted  with  his  own  child.  He  proved 
to  be  one  of  the  few  fathers  of  illegitimate  children  who  had,  in  her  experience, 
shown  an  interest  in  their  babies.  v  His  was  at  once  an  almost  maternal  devotion. 
So  marked  was  this  feeling  that  she  encouraged  the  marriage.  The  home  was 
happy  and  prosperous. 

A  girl  with  a  young  baby  applied  to  this  same  children’s  society  to  secure  support 
from  her  deserting  husband.  The  man’s  relatives  claimed  that  he  had  not  seen  his 
wife  for  three  years  and  was  not  the  father  of  her  baby.  The  evidence  narrowed 

144 


THE  FAMILY  GROUP 


« 


down  to  the  conflicting  statements  of  the  two  sets  of  relatives  (his  and  hers), 
and  both  were  of  unestablished  reliability.  Finally  a  meeting  was  arranged 
between  man  and  wife  in  the  presence  of  the  agent,  and  he  acknowledged  his 
parenthood. 

A  charity  organization  society  was  asked  by  a  hospital  to  befriend  an  unmarried 
mother  of  twenty  with  a  two-weeks-old  baby.  She  named,  as  father  of  the  child, 
a  young  fellow  who  had  come  from  a  refined  home.  He  was  not  in  the  city  and 
wrote  to  his  mother  denying  everything.  An  interview  arranged  between  the 
mother  and  the  young  girl  convinced  the  older  woman  that  the  girl  was  telling  the 
truth.  This  did  not  lead  to  marriage,  but  to  weekly  payments  toward  the  support 
of  the  child.  From  the  community’s  standpoint  it  is  quite  as  important  to  deal 
with  the  unmarried  father  as  with  the  unmarried  mother. 

4.  The  Young  Couple.  That  the  wife  and  one  or  two  babies  of 
a  young,  able-bodied  man  should,  in  ordinary  times,  need  any 
social  service  that  involves  material  relief  also  is  a  situation  which 
demands  the  closest  scrutiny.  To  discover  all  the  reasons  for 
the  trouble,  if  possible,  and  deal  with  them  one  by  one  is  more 
difficult  than  to  give  temporary  help,  but  an  irresponsible  inter¬ 
ference  with  their  affairs  is  worse  than  none.  Notes  on  the  re¬ 
corded  treatment  of  two  young  couples  by  a  charity  organization 
society  are  as  follows: 

Italian  couple,  both  twenty-three,  with  children  four,  two,  and  one  just  born. 
Non-supporting.  The  first  interview  and  succeeding  investigations  do  not  bring 
out  clearly  when  the  man  began  to  be  neglectful;  whether  he  had  exhibited  the 
same  traits  before  marriage;  if  they  first  appeared  after  marriage,  under  what 
circumstances;  and  what  or  who  was  the  exciting  cause.  There  should  have  been  a 
much  more  searching  inquiry  among  other  relatives  and  old  employers,  and  possibly 
friends  of  both  before  their  marriage.  Here  is  a  pauper  family  in  the  making.  It 
is  either  hopeful  or  otherwise.  We  do  not  know  the  woman’s  real  character  at  all. 
We  do  not  know  how  far  back  the  man’s  present  slackness  goes.  If  everything 
points  to  absolute  degeneracy  on  his  part,  far  greater  influence  (through  relatives 
and  others)  should  be  used  to  break  up  the  family.  If  not,  then  the  case  is  still 
left  in  the  air,  because  no  further  treatment  has  been  provided. 

This  is  the  case  of  a  deserter  from  the  Navy  with  a  young  wife  (epileptic)  and  a 
two-and-a-half-year-old  child.  A  quite  compact,  satisfactory  investigation,  with 
a  good  chronologically  arranged  first  statement.  A  very  satisfactory  use  of  six 
sources  of  information,  though  there  are  reasons  why  the  second  relative  should 
have  been  seen  also.  But  with  the  return  of  the  man  in  February,  the  summary 
closing  of  the  case  on  February  1 5  was  not  wise.  The  man  is  inclined  to  be  lazy, 
he  has  a  very  loving  wife  who  is  liable  to  “baby”  him  a  good  deal  on  account  of 
what  she  will  consider  the  hard  time  that  he  has  been  through.  The  wife  has  been 
put  into  a  janitress’s  position  (only  rent  free  and  $1.00).  The  wisdom  of  having 

145 


10 


SOCIAL  DIAGNOSIS 


her  start  in  again  to  do  work  outside  her  own  home  is  very  doubtful.  It  will  be 
necessary  to  keep  in  constant  touch  with  this  man  by  volunteer  aid  or  long  reach 
from  the  office — letters  and  sometimes  calls.  There  are  all  the  tendencies  present 
for  a  complicated  problem  five  years  hence.  Deal  with  them  now! 

5.  Desertion  and  Inebriety.  These  two  disabilities,  which 
are  treated  more  fully  in  two  of  the  questionnaires,  illustrate  the 
controlling  influence  upon  diagnosis  of  a  program  of  social  treat¬ 
ment.  In  the  days  when  no  distinction  was  made  between  the 
social  treatment  of  the  wife  and  children  of  a  deserter  and  that  of  a 
widow’s  family  there  was  little  reason  for  mastering  the  history 
of  the  desertion  or  desertions  and  the  characteristics  of  the  de¬ 
serter.  But  with  the  development  of  a  new  sense  of  social  re¬ 
sponsibility  for  the  deserter’s  movements  and  relations  to  his 
wife  and  children,  with  provisions  for  his  extradition,  release  on 
probation,  payments  to  family  through  the  court,  etc.,  has  come 
a  new  reason  for  differential  treatment  based  upon  differential 
diagnosis.  Is  he  really  a  deserter,  or  are  there  reasons  to  believe 
that  he  is  in  communication  with  his  family  and  still  in  their  im¬ 
mediate  neighborhood?  The  history  of  former  desertions,  if  any, 
may  throw  light  upon  the  reasons  for  this  one  and  upon  the  man’s 
probable  movements.  Even  if  not  in  communication  with  his 
own  family,  more  often  than  not  he  will  have  continued  to  keep  up 
relations  with  someone — with  his  own  relatives,  with  former  shop 
mates,  or  with  old  cronies.  Are  his  relatives  inclined  to  shield 
him  or  are  they  harboring  him  perhaps?  If  there  is  any  chance  of 
taking  court  action,  proof  of  his  marriage  may  be  necessary.  Not 
all  deserters  are  equally  culpable.  An  understanding  of  their 
difficulties  and  their  points  of  view  makes  it  clear  that,  given  the 
right  impetus,  many  of  them  are  far  from  hopeless  as  family  men. 
It  is  more  important  to  understand  the  main  drift  of  their  lives  than 
the  one  incident  which  brings  them  to  our  attention,  whether  this 
is  an  isolated  one  or  the  climax  in  a  series  of  mistaken  choices. 
The  foundations  of  such  an  understanding  are  best  laid  in  our  early 
contacts  with  the  Family  Group. 

Alcoholism  is  a  disability  which  presents  quite  as  great  a  variety 
of  possibilities  as  desertion.  In  fact,  there  is  no  social  disability 
in  the  treatment  of  which  more  use  can  be  made  of  such  indices  to 
personality  as  will  power,  sociability,  capacity  for  affection,  and 

146 


THE  FAMILY  GROUP 


susceptibility  to  religious  influence.1  The  problem  has  its  medical 
aspects;  the  man’s  bodily  and  mental  condition  and  the  habits 
and  mentality  of  his  forebears  are  often  the  most  important  factors, 
but  the  social  side  is  important  too.  Such  environmental  factors 
as  the  temperament  of  his  wife,  the  comfort  of  his  home,  the  family 
cooking,  the  conditions  and  nature  of  his  daily  employment,  the 
character  of  his  companions,  need  only  to  be  mentioned  to  suggest 
a  possible  relation  to  his  drink  habits.  These  habits  themselves 
vary  in  different  men.  Some  are  accidental  drunkards;  some  free 
drinkers  who  occasionally  get  drunk;  some  are  unable  to  touch 
.alcohol  without  being  overcome  by  it;  some  always  drink  with 
others;  some  are  solitary  drinkers;  some  are  using  drugs  also  or  have 
substituted  alcohol  for  a  drug.  “  The  treatment  of  the  inebriate  can 
best  be  expressed,”  says  Dr.  Neff,  “  in  the  word  ‘  individualization/  ”2 
and  the  foundations  of  individualized  social  treatment  are  best 
laid  in  early  contacts  with  and  observations  of  the  Family  Group. 

III.  THE  WIFE  AND  MOTHER 

The  household  speaks  for  the  wife,  answering  unasked  questions 
about  her  as  it  does  not  about  the  husband.  The  wife’s  maiden 
name  will  aid  in  identifying  her  kindred  and  will  enable  references 
who  knew  her  only  before  her  marriage  to  place  her.  (In  Italian 
families  she  is  still  often  known  by  her  name  instead  of  her  hus- 
bMid’s.)  Her  maiden  name  may  also  aid  in  bringing  to  light 
the  records  of  related  families  under  treatment.  She  remem¬ 
bers  birthdays  and  ages  and  church  connections  better  than  the 
man  does,  and  is  the  first-hand  authority  on  the  family  budget, 
more  especially  the  outgo.  Her  schooling  and  her  work  and  wages 
before  marriage  help  to  place  her,  as  does  also  her  account  of  how 

1  “There  is  a  passage  in  one  of  Miss  Octavia  Hill’s  essays  that  throws  a  flood  of 
light  on  this  question.  She  says  that  the  love  of  adventure,  the  restlessness  so 
characteristic  of  the  Anglo-Saxon,  makes  him,  under  certain  conditions,  the  greatest 
of  explorers  and  colonizers,  and  that  this  same  energy,  under  other  conditions, 
helps  to  brutalize  him.  Dissatisfied  with  the  dull  round  of  duties  that  poverty 
enforces  upon  him,  he  seeks  artificial  excitement  in  the  saloon  and  the  gambling 
den.  It  is  useless  to  preach  contentment  to  such  a  man.  We  must  substitute 
healthier  excitements,  other  and  better  wants,  or  society  will  fail  to  reform  him.” — 
Friendly  Visiting  among  the  Poor  by  M.  E.  Richmond,  p.  128. 

2  See  Proceedings  of  National  Conference  of  Charities  and  Correction  for  1911 
(Boston),  p.  135. 


147 


SOCIAL  DIAGNOSIS 


she  and  her  husband  first  met,  and  of  their  pre-matrimonial  ac¬ 
quaintance.  Details  of  her  work  since  marriage,  of  its  relation  to 
her  health,  to  care  of  home  and  children,  to  her  husband’s  exer¬ 
tions,  and  the  attitude  of  her  family  and  friends  toward  her  work 
are  all  of  them  important. 

If,  in  tracing  the  main  current  of  the  family  life,  it  becomes 
evident  that  there  have  been  marked  changes  in  home  standards, 
what  has  been  the  wife’s  share  in  these  changes?  If  her  home 
standard  was  fair  at  one  time  and  now  is  low,  what  factors  have 
entered  in — extreme  poverty,  too  many  children,  overwork,  her 
own  or  other  family  illnesses?  In  estimating  the  physical  in¬ 
fluence  of  childbearing,  the  children  who  have  died  and  any  mis¬ 
carriages  must  also  be  included.  Not  only  her  husband’s  habits 
but  her  own  must  be  known  and  understood.  If,  for  example, 
she  is  a  gossip  who  neglects  her  household  duties  and  spends  much 
time  away  from  home,  what  poverty  of  opportunity  and  of  in¬ 
terests,  what  recreational  need  that  can  possibly  be  met  is  behind 
this?  The  drink  habit  is  not  always  confined  to  the  man  of  the 
family.  Even  where  husband  and  wife  both  drink  the  one  habit 
may  have  two  quite  different  histories. 

1.  Physical  Aspects  of  Homemaking.  A  household  may  be  in 
a  good  deal  of  disorder  and  still  be  essentially  cleanly.  The  re¬ 
verse  is  true,  of  course,  and  the  distinction  is  worth  making.  Has 
the  wife  learned  to  sew?  Does  she  take  pleasure  in  making  the 
most  of  the  family  wardrobe,  or  has  she  lost  or  never  had  this  interest 
in  clothes?  What  does  she  know  about  cooking?  I s  she  a  good  buyer? 

Upon  questions  of  “income  and  outgo”  the  wife  and  mother  is, 
as  has  been  said,  the  best  authority.1  Details  given  under  this 
head  in  the  first  of  the  questionnaires  need  not  be  repeated  here, 
but  one  important  point,  not  capable  of  outside  verification,  should 
be  emphasized.  The  food  habits  of  the  family  must  be  known  in 
many  forms  of  case  work,  because  these  habits  are  so  closely  re¬ 
lated  to  the  family’s  health  and  to  its  efficient  use  of  income.  The 
homemaker  knows  what  food  is  bought  and  eaten,  of  course,  but 
unless  she  keeps  accounts,  her  estimate  as  to  the  total  cost  of  any 
item  of  her  family  budget  is  worth  very  little.  A  case  worker  and 

1  The  wife  does  not  always  know  the  earnings  of  her  husband  and  older  children, 

however. 

148 


THE  FAMILY  GROUP 


dietitian  tells  of  an  English-speaking  Polish  woman  with  five  chil¬ 
dren  who,  when  asked  how  much  per  week  was  needed  to  buy  food 
for  her  family,  said,  with  a  manner  that  indicated  the  amount  might 
seem  excessive  to  her  visitor,  “  I  think  I  must  have  $2.00.” ) 

No  mere  account  of  food  purchases  and  prices,  moreover,  can 
give  all  the  data  needed,  for  details  of  choice,  preparation,  and  con¬ 
sumption  are  half  the  story.  And  any  inferences  drawn  from  these 
details  must  take  into  account  not  only  such  obvious  factors  as  the 
size  of  the  family,  and  the  ages  and  occupations  of  its  members, 
but  those  conditions  of  health  and  those  national  and  religious  char¬ 
acteristics  which  have  a  marked  influence  upon  food  consumption. 
Even  so  definite  a  matter  as  the  size  of  the  family  is  complicated,  in 
some  immigrant  households,  by  the  presence  of  boarders  for  whom 
the  housewife  cooks  food  provided  separately  by  each  boarder.1 

Another  modifying  factor  is  the  amount  of  time  and  skill  that 
the  housewife  has  to  devote  to  homekeeping.  Most  economies 
in  money  call  for  an  increased  outlay  of  work  and  skill.  In  fact, 
the  housewife’s  skill  is  “an  asset  which  must  be  included  in  the 
family  resources.”2 

Any  study  of  food  questions  has  a  very  stimulating  effect  upon 
the  homemaker  when  she  shares  in  the  whole  process.  She  needs 
some  such  stimulation  of  interest,  for  her  devotion  to  a  difficult 
round  of  tasks  is  often  taken  entirely  for  granted. 

When  we  confine  our  attention  to  the  strictly  diagnostic  aspects 
of  the  food  question,  the  greatest  difficulty  encountered  will  be  with 
the  housewife  who  cannot  keep  good  accounts  or  any.  This  handi¬ 
cap  means  more  frequent  visits,  some  of  them  at  meal  times  per¬ 
haps.  As  the  housewife  knows  what  she  has  just  bought,  a  start 
in  getting  the  rough  outlines,  at  least,  of  food  consumption  may 
be  had  by  working  on  a  day  basis  and  trying  to  discover,  concern¬ 
ing  each  of  the  staple  articles  which  every  family  is  supposed  to 
have,  just  what  has  been  bought  and  eaten. 

1  What  is  left  over  commonly  goes  to  the  family,  hence  it  becomes  practically 
impossible  to  estimate  the  money  expended  by  the  family  or  the  amount  of  food  that 
they  have.  The  visitor  may  judge  unfairly  too,  when  she  sees  the  boarder’s  chicken 
cooking  and  assumes  that  it  belongs  to  the  family.  On  the  other  hand,  the  family 
may  claim  that  its  own  bountiful  meal  belongs  to  the  boarders. 

2  Byington,  Margaret  F.:  Homestead,  the  Households  of  a  Mill  Town,  p.  74. 
New  York,  Russell  Sage  Foundation  Publication,  Charities  Publication  Com¬ 
mittee,  1910. 


I49 


SOCIAL  DIAGNOSIS 


The  dietitian  of  a  public  department  administering  mothers’  pensions  reports 
the  following  items  of  experience:  “The  department  requires  that  household  ac¬ 
counts  be  kept  by  the  pensioners,  and,  though  an  untrained  woman  seldom  keeps 
accurate  accounts,  wilful  inaccuracies  usually  show  either  (i)  impossible  amounts 
of  a  given  article,  (2)  costs  which  do  not  correspond  with  amounts  purchased,  or  (3) 
monotonous  repetition  of  the  same  few  items.  Entire  absence  of  some  essential 
is  often  an  unintentional  inaccuracy.” 

This  dietitian  finds  that  the  best  avenue  of  approach  to  the  food  question  is  an 
anemic  or  undersized  child.  The  attention  of  the  mother  is  called  to  the  fact  that 
the  child  does  not  look  particularly  strong,  and  she  is  asked  whether  he  has  a  good 
appetite.  What  did  he  eat  for  breakfast  this  morning?  How  does  this  compare 
with  what  the  other  children  ate?  If,  as  frequently  happens,  the  breakfast  was 
“  bread  and  coffee,”1  this  gives  a  chance  for  explaining  the  value  of  milk  and  cereals. 
The  topic  of  the  children’s  luncheon,  especially  that  of  the  school  children,  naturally 
follows.  Do  they  come  home  to  a  hot  luncheon  or  do  they  buy  bakery  buns  and 
cakes?  Is  their  chief  meal  at  noon  or  at  night?  Is  it  a  meal  at  which  all  sit  down 
together  to  eat,  or  do  the  different  members  of  the  family  eat  how  and  where  they 
please?  Is  the  dietary  for  adults  and  for  younger  children  the  same?  When  the 
mothers  have  once  realized  that  an  interest  in  the  health  of  the  family  and  not  a 
desire  to  cut  down  monthly  allowances  is  behind  these  questions,  the  response  has 
usually  been  a  cordial  one. 

Each  visitor  of  this  department  is  provided  with  a  schedule  of  the  normal  weights 
of  children  of  given  ages,  and  secures,  for  the  neighborhood  in  which  she  is  working, 
a  list  of  prices  of  staple  foods  in  the  stores  in  which  prices  and  quality  are  most 
satisfactory. 


After  the  actual  food  habits  of  the  family  have  been  clearly 
grasped — a  thing  that  cannot  usually  be  achieved  in  one  or  two 
visits — the  question  of  finding  the  remedy  for  defects  and  inade¬ 
quacies  remains  unsettled.  A  fair  standard  of  food  values  and 
costs  should  be  the  basis  of  any  budgetary  estimate,  but,  as  regards 
costs,  the  modifications  necessary  for  each  locality  and  each  marked 
change  in  market  rates  should  be  worked  out  more  carefully  than 
they  have  been  by  family  agencies.  A  unit  of  cost  per  person 
estimated  for  the  whole  country  years  ago  can  be  very  misleading. 
We  must  know  also  the  health  conditions  and  the  family  or  indi¬ 
vidual  idiosyncrasies  that  should  modify  our  estimate.  If  all  of 
the  family  are  found  to  be  in  good  physical  condition  on  a  smaller 
food  allowance  than  our  estimated  local  standard,  should  the 
standard  be  urged,  or  should  this  variation  be  ignored?  All  of 

1  Dr.  Healy  says  in  Honesty  (p.  105)  that,  unexpectedly,  he  found  the  overuse 
of  tea  and  coffee  one  of  the  most  frequent  causes  of  delinquency  in  children. 

150 


THE  FAMILY  GROUP 


these  matters  are  important;  most  of  them  do  not  belong  here, 
however,  but  in  a  discussion  of  the  later  stages  of  treatment. 

2.  The  Family  Housing.  The  following  list  of  the  housing  defects 
that  are  serious  enough  to  arrest  the  attention  of  social  workers, 
no  matter  what  their  errand  to  the  home,  is  an  amplification  of 
one  prepared  by  the  writer  in  191 1 T  Not  all  of  these  things  can  be 
covered  in  one  visit,  of  course,  or  in  two,  but  all  are  important. 

a.  Bad  Toilet  Arrangements.  We  visit  homes  frequently  where  there  is  inertia, 
low  vitality,  or  even  sickness  without  knowing  definitely  or  taking  the  trouble  to 
discover  the  condition  of  the  plumbing,  the  trapping  of  the  waste  pipes,  etc.  The 
cleanliness  of  the  toilets,  their  location  and  provisions  for  privacy,  such  as  inside 
locks,  have  a  bearing  upon  health  and  decency.  An  untrapped  waste  pipe  means 
sewer  gas,  probably,  and  sewer  gas  means  ill  health.  Where  there  are  outside  vaults 
a  menace  to  health  from  fly  infection  always  exists,  while  inconvenience  of  access  and 
noisome  odors  combine  to  make  the  condition  one  of  the  most  serious  of  housing  evils. 

b.  Dampness.  The  condition  of  the  cellar,  the  walls,  and  the  roof,  more  espe¬ 
cially  of  the  cellar;  is  its  floor  wet  or  damp,  has  it  a  dirt  or  a  cement  floor,  is  it 
cluttered  with  rubbish  or  animals?  Are  the  pipes  leaking?  Does  the  roof  leak? 

c.  Dark  Rooms.  When  these  are  used  for  bedrooms,  the  fact  should  be  noted  on 
our  records,  should  be  related  to  our  family  histories  of  disease  and  premature 
death,  and  should  be  made  the  subject  of  steady  pressure  upon  citizens,  lawbreakers, 
and  public  administrators. 

d.  Overcrowding.  This  is  especially  to  be  noted  as  regards  sleeping  accommoda¬ 
tions.  Its  vital  relation  to  health,  particularly  to  the  spread  of  tuberculosis,  and 
to  decency  must  be  vividly  realized  and  kept  constantly  in  mind  in  all  our  plans  for 
making  people  economically  independent.  Independence  built  upon  a  standard 
that  ignores  decency  is  built,  of  course,  upon  quicksand.  In  this  connection  the 
taking  of  lodgers  and  boarders  is  especially  important  because  of  the  physical, 
moral,  and  social  dangers  involved. 

e.  Insufficient  Water  Supply.  In  the  purity  of  the  source  and  the  amount  are  in¬ 
volved  the  condition  of  the  cistern  or  tank  and  its  care  between  official  inspections. 
Is  there  running  water  and,  if  not,  where  is  the  nearest  tap? 

When  we  have  trained  ourselves  to  observe  these  things,  we 
shall  find  that  the  unhealthful  conditions  discovered  are  some  of 
them  violations  of  existing  statutes,  others  not.  With  regard  to 
the  first  group,  we  should  lose  no  time,  of  course,  in  reporting  to 
the  right  place  bad  conditions  that  really  are  violations.  The  second 
group  furnish  arguments  for  further  legislation,  but  they  do  this 
only  when  they  are  promptly  and  accurately  recorded.  Pending 

1  See  Proceedings  of  National  Conference  of  Charities  and  Correction  for  1911 
(Boston),  p.  327-328. 

15  I 


SOCIAL  DIAGNOSIS 


the  securing  and  enforcement  of  such  legislation,  it  is  possible  to 
keep  the  worst  houses  and  tenements  empty  by  persuading  tenants 
to  move,  and  it  is  possible  to  remedy  the  less  serious  nuisances 
with  their  co-operation.  It  has  also  been  found  practicable  some¬ 
times  to  appeal  directly  to  landlords  who  had  been  in  the  habit, 
earlier,  of  leaving  the  management  of  their  properties  to  agents, 
and  persuade  them  to  correct  the  evils  complained  of. 

IV.  THE  CHILDREN 

Here  we  find  blood  relationship  and  all  those  undercurrents  of 
sympathy  and  antagonism  which  it  implies.  Propinquity  only 
aggravates  any  natural  lack  of  sympathy.  Between  kindred  such 
lacks  are  often  fundamental.  Often,  however,  as  Mrs.  Bosanquet 
points  out,  antagonism  is  due  not  so  much  to  fundamental  dif¬ 
ferences  as  to  the  assumption  that  there  should  be  no  difference. 
The  implacable  attitude  of  child  toward  parent,  parent  toward 
child,  and  of  brothers  and  sisters  toward  one  another  is  due  to 
likenesses  even  more  than  to  differences.  “That  a  member  of 
the  family,  sharing  in  its  common  nature,  partaking  in  its  im¬ 
pulses,  instincts,  sentiments,  and  education,  can  have  done  this 
thing — it  is  that  which  wounds  deeper  than  all  the  scorn  or  pity 
from  the  outside,  for  it  reveals  possibilities  unrealized  before/’1 
A  probation  officer  tells  of  a  girl  in  her  care  who  held  a  grudge 
grimly  against  her  mother  for  three  years  because  she  complained 
of  her  to  the  juvenile  court  at  a  critical  time.  So  often  do  parents’ 
complaints  to  the  court  cause  open  rebellion  and  permanent 
estrangement  that  this  officer  strives  in  every  possible  way  to 
settle  such  difficulties  without  appearing  in  them. 

One  common  cause  of  estrangement  is  the  inability  of  children 
to  give  expression  to  their  ambitions  or  to  find  a  natural  outlet  for 
their  energies.  The  effects  of  these  checks  are  intensified  in  any 
family  that  is  passing  through  a  sudden  change  of  economic 
status,  whether  that  change  be  favorable  or  the  reverse.  The 
response  of  the  different  members  to  the  outward  change  is  a 
varied  response;  the  upheaval  which  depresses  and  alienates  one 
member  acts  as  a  stimulus  to  the  energies  and  affections  of  another, 
with  the  result  that  all  are  thrown  out  of  their  accustomed  relation 

1  The  Family,  p.  257. 

152 


THE  FAMILY  GROUP 


to  one  another.  The  human  situation  thus  created  has  been  a 
favorite  theme  of  English  fiction  from  the  Vicar  of  Wakefield  to 
the  latest  best  seller. 

Other  causes  of  estrangement  are  the  unwise  reticences  of.  pa¬ 
rents  and  their  failure  to  appreciate,  at  critical  periods,  the  physi¬ 
cal  reasons  for  a  child’s  lack  of  control.  “There  is  the  most  definite 
necessity,”  says  Dr.  Healy,1  “for  little  people  telling  what  they  have 
seen  and  what  they  have  done.  For  them  to  bottle  up  within 
themselves  affairs  of  importance  is  a  dangerous  proceeding.  We 
should  most  earnestly  counsel  that  children  should  be  accustomed 
to  go  over  the  items  of  their  daily  life  with  their,  guardians  that 
there  may  be  no  hidden  knowledge  to  be  dwelled  on  in  morbid 
fashion.  Of  all  forms  of  prevention  of  delinquency  I  know  of 
nothing  comparable  to  the  confidences  and  counsels  between  elders 
and  children.” 

It  is  a  commonplace  of  child-saving,  of  course,  that  a  child 
placed  away  by  one  or  both  parents  loses,  in  large  degree,  the  sense 
of  family  solidarity. 

The  mother’s  attitude  toward  her  children  and  theirs  toward 
her  are  easily  observed  as  they  come  and  go  in  the  home.  A 
medical-social  worker  says  that  if,  after  the  immediate  purpose 
of  her  visit  to  a  home  is  accomplished,  she  has  occasion  to  wait 
to  make  a  train  and  busies  herself  with  a  book  or  some  work  mean¬ 
while,  the  members  of  the  family,  ceasing  to  react  to  her,  begin 
to  react  to  one  another,  and  she  gets  an  impression  of  the  home 
that  she  might  miss  altogether  otherwise.  Have  the  parents  good 
control  over  their  children?  Do  the  latter  seem  afraid  of  either 
parent?  Are  they  punished  in  anger,  or  is  self-control  exercised? 
The  unfortunate  practice  of  some  teachers,  nurses,  and  social 
workers  of  dealing  with  the  family’s  affairs  almost  entirely  through 
the  medium  of  the  children  has  a  definite  bearing  upon  the  loss  of 
respect  for  parents  which  is  so  marked  a  characteristic  of  the  young 
people  in  certain  families. 

Mention  has  been  made  of  the  failure  of  many  children’s  in¬ 
stitutions  and  societies  to  study  the  family  backgrounds  of  their 
wards.  Quite  as  grave  an  omission  is  the  failure  in  many  family 
agencies  to  individualize  each  child  in  the  families  under  their 

1  Honesty,  p.  177. 

153 


SOCIAL  DIAGNOSIS 


care.  Aside  from  the  consultation  of  school  records  and  possible 
court  records,  both  of  which  are  items  to  be  covered  outside  the 
home,  visits  to  the  home  itself  should  lead  to  inquiries  as  to  the 
physical  and  mental  condition  of  every  child  showing  any  varia¬ 
tion  from  the  normal,1  and  should  also  give  us  a  clear  impression 
of  the  temperament  of  each  of  the  children.  What  are  their  apti¬ 
tudes,  their  ambitions,  their  small  achievements?  The  sleeping 
arrangements  for  the  children,  both  with  reference  to  their  health¬ 
fulness  and  their  decency,  are  an  important  point.  So  are  their 
recreations.  Are  their  small, ^individual  possessions  respected? 
Have  they  any?  What  opportunities  have  they  for  sharing 
pleasures  and  duties  as  a  part  of  the  family?  Is  there  any  indica¬ 
tion  that  they  are  overworked  at  home  duties?  That  they  are 
doing  sweatshop  work  at  home?  Are  they  sent  to  charity  offices 
with  messages  which  should  be  taken  there  by  adults  only?  Are 
they  sent  out  to  beg?  Are  they  illegally  employed?  It  should  be 
unnecessary  to  add  that  inquiries  about  the  children,  especially 
with  regard  to  matters  involving  their  conduct,  should  not  be  made 
in  their  presence. 

1.  The  Matter  of  Ages.  The  ages  of  any  children  in  the  family 
who  are  still  minors  may  become  so  very  important  at  any  time 
that  the  recording  of  them  with  exactness  must  be  urged.  The  only 
way  to  be  absolutely  sure  of  ages  is  to  have  day,  month,  and  year  of 
birth  in  each  case  and  to  verify  these  from  official  records.2  Their 
importance  is  shown  from  the  following  list  of  actions  and  judg¬ 
ments  in  which  such  dates  must  be  used: 

a.  Prosecution  of  parent  for  desertion  or  abandonment  of  infant. 

b.  Bastardy  charges. 

c.  Establishing  legitimacy  or  a  previous  marriage.  ' 

d.  Identification  of  a  family  (where  names  are  incorrectly  given). 

e.  Collecting  insurance. 

f.  Choice  of  a  guardian. 

g.  Prosecution  of  parent  for  cruelty  or  neglect. 

h.  Choice  of  institutions  for  temporary  placing  or  for  commitment. 

i.  Entering  in  school  and  requiring  school  attendance. 

j.  Establishing  legal  date  for  going  to  work,  for  engaging  in  street  trading,  etc. 

k.  Establishing  legal  hours  of  work. 

1  See  questionnaires  on  the  Neglected  Child  and  on  the  Child  Possibly  Feeble¬ 
minded  in  Part  III. 

2  See  p.  256  sq. 


154 


THE  FAMILY  GROUP 


1.  Protecting  from  certain  injurious  employments. 

m.  Deciding  right  of  parent  to  collect  wages  of  child  or  receive  support  from  him. 

n.  Bringing  suit  for  accident  indemnity. 

o.  The  age  of  consent. 

p.  Fixing  period  during  which  alimony  is  payable  in  cases  of  legal  separation  or 

divorce  of  parents. 

q.  Securing  special  transportation  rates. 

r.  Establishing  the  legality  of  a  minor’s  marriage.1 

The  secretary  of  the  Massachusetts  S.  P.  C.  C.  puts  this  matter  more  concretely 
as  follows:  One  day  after  a  child  is  fourteen  he  can  nominate  a  guardian;  one  day 
after  he  is  fifteen  he  cannot  be  sent  to  the  Industrial  School;  one  day  after  he  is 
sixteen  his  case  cannot  be  considered  in  court  under  the  Neglect  Law;  one  day 
after  he  is  seventeen  he  cannot  be  considered  a  juvenile  offender;  one  day  after  she  is 
seventeen  a  girl  cannot  be  committed  to  the  Lancaster  School  [girls’  reformatory]. 

Not  only  the  month  but  the  exact  day  is  essential  in  all  the 
foregoing.  In  recording  the  ages  of  parents,  the  year  is  usually 
sufficient,  unless  a  parent  also  is  a  minor. 

2.  The  Older  Children.  The  educational  side  of  the  children’s 
lives  is  discussed  in  Chapter  XI,  Schools  as  Sources.  It  need  not 
detain  us  here.  When  the  children  are  about  to  leave  school, 
their  special  aptitudes  and  their  ambitions  become  very  important 
matters.  Are  they  thrust  into  dead-end  occupations?  Are  they 
frequently  shifted  about  from  one  job  to  another?  These  are  the 
years  in  a  child’s  life  when  highly  individualized  case  work  is  often 
needed  to  supplement  whatever  plans  of  vocational  guidance  have 
been  developed  in  the  schools. 

The  attitude  of  the  wage-earning  child  who  takes  the  turning 
over  of  _all  his  earnings  to  his  parents  as  a  matter  of  course,  and 

1  Miss  Amelia  Sears,  to  whom  the  writer  is  indebted  for  most  of  the  items  in  this 
list,  gives  the  following  additional  reasons  for  seeking  the  exact  ages  of  children: 

“If  .  .  .  there  is  a  lapse  of  three  or  four  years  between  the  births  of  two 

children  in  a  large  family  where  most  of  the  children  have  come  close  together,  three 
possibilities  occur  to  the  experienced  case  worker:  First,  the  parents  may  have  lost 
a  child;  second,  there  may  have  been  a  second  marriage  on  the  part  of  either  the 
father  or  the  mother;  third,  the  parents  may  have  been  separated  for  a  period. 
The  reply  to  a  question  concerning  such  a  lapse  sometimes  reveals  a  former  deser¬ 
tion  hitherto  unmentioned;  sometimes  the  separation  of  the  parents  at  the  time  of 
migration  to  America,  when  the  father  may  have  preceded  the  mother  by  several 
years;  or  occasionally,  a  period  of  incarceration  of  one  of  the  parents  in  a  peni¬ 
tentiary  or  a  hospital  for  the  insane.  On  the  other  hand,  the  ages  of  the  children 
not  infrequently  conflict  with  statements  of  the  parents  concerning  desertion,  mi¬ 
gration  or  imprisonment.  The  explanation  sometimes  discloses  efforts  at  deceit  in 
the  matter  of  the  children’s  ages,  and  sometimes  the  fact  of  promiscuous  living  on 
the  part  of  the  parents.’’ — The  Charity  Visitor,  p.  29. 

155 


SOCIAL  DIAGNOSIS 


whose  parents  have  always  so  taken  it,  may  lead  to  insubordina¬ 
tion  later  on.  A  natural  reaction  from  complete  subjection  is 
pushed  too  far  by  the  spirit  of  his  new  associates  and  by  the  in¬ 
vitations  of  his  enlarged  world.  From  the  very  beginning,  the 
social  worker  must  keep  these  future  dangers  in  mind  and  seek  a 
better  adjustment. 

Separate  interviews  with  the  grown  sons  and  daughters  of  a 
household,  especially  with  those  who  are  wage-earners,  are  often 
necessary. 

A  woman  of  sixty-four  had  been  known  to  a  charitable  society  for  many  years, 
but  her  six  children,  of  ages  ranging  from  thirty-two  to  eighteen,  had  not  been  con¬ 
sulted  about  her  unexplained  habit  of  writing  begging  letters  continually.  A  critic 
of  the  record  writes:  “My  belief  is  that,  in  order  to  know  the  real  inwardness,  each 
and  every  son  and  daughter  should  be  seen  away  from  the  home.  Practically  all  the 
dealings  in  later  years  have  been  with  the  woman.  I  observe  that  the  last  record 
of  any  one  of  them  being  seen  was  made  six  years  ago.  Even  then  it  was  purely 
incidental.  What  manner  of  people  are  these  sons  and  daughters  now?  How  do 
they  feel  about  these  constant  appeals?  What  influence  are  they  bringing  to  bear 
upon  their  mother?  Do  they  countenance  the  habit?” 

V.  OTHER  MEMBERS 

Relatives  of  the  husband  or  of  the  wife  often  form  a  part  of  the 
Family  GrouA ,  whether  with  a  clearly  defined  share  of  family  re¬ 
sponsibility  or  with  none.  Sometimes  they  carry  far  more  than 
their  share  of  the  family  burden;  sometimes  their  influence  is  so 
disturbing  as  to  disrupt  the  home — a  mischief  often  wrought  by 
relatives  who  live  elsewhere,  but  more  completely  achieved  by 
those  under  the  same  roof.  Records  studied  for  this  book  seem 
to  show  an  undue  share  of  undesirable  relatives  in  widow's  families, 
where  there  is  no  man  to  send  them  packing. 

In  one  case,  a  drunken  father  left  the  home  of  his  more  well-to-do  children  to 
live  with  his  widowed  daughter  and  her  small  brood  just  as  soon  as  a  regular  al¬ 
lowance  from  a  social  agency  had  been  organized  for  them.  The  widow  was  an 
easy-going  person,  for  later  she  married  a  man  that  was  more  of  a  vagabond  than 
her  father  even.  The  givers  of  the  allowance  conditioned  its  continuance,  up  to  the 
time  of  the  second  marriage,  upon  the  father’s  withdrawal. 

In  another  widow  record,  the  woman’s  brother  was  boarding  with  her.  His 
influence  upon  the  growing  boys  was  found  to  be  bad,  and  further  aid  was  made 
conditional  upon  his  leaving. 

We  must  not  lose  sight  of  the  strong  relatives  who  sometimes  as 

156 


THE  FAMILY  GROUP 


part  of  the  Family  Group,  carry  more  than  their  share  of  its  burdens ; 
nor  of  those  no  longer  able  to  earn  who  to  that  extent  are  a 
charge,  yet  who  may  be  holding  the  group  closer  together  and  mak¬ 
ing  a  very  definite  contribution  to  the  family  life  in  their  ability 
to  give  and  to  evoke  real  affection.  There  can  be  a  natural  com¬ 
radeship  between  grandparents  and  the  younger  grandchildren,  for 
instance,  which,  where  it  exists,  is  an  invaluable  part  of  the  home 
environment  of  a  child. 

In  cases  of  desertion  it  is  often  necessary  to  consider  not  only  the 
influence  of  relatives  who  are  or  have  been  members  of  the  house¬ 
hold,  but  that  of  any  lodgers  or  boarders  who  are  not  kindred. 
Their  relations  with  the  husband  or  with  the  wife  sometimes 
help  to  explain  marital  differences.  In  any  case,  their  habits 
have  a  direct  influence  upon  the  children,  and  the  amount  and 
regularity  of  their  payments  are  an  important  item  in  figuring 
the  budget. 

If,  in  the  foregoing  discussion  of  earlier  visits  to  the  home,  more 
emphasis  seems  to  have  been  put  upon  getting  an  idea  of  its  back¬ 
ground  and  its  trend  than  upon  the  separate  items  of  fact  needed 
for  the  face  cards  of  case  records,  it  must  not  be  inferred  that  in¬ 
exact  and  general  impressions  are  in  any  wise  recommended  as 
substitutes  for  definiteness  and  concreteness.  But  a  fact,  however 
exactly  stated,  has  little  significance  until  it  has  been  intelligently 
related  to  some  other  fact  or  facts,  so  that  skill  is  shown,  not  so 
much  in  the  ability  to  accumulate  a  mass  of  data  as  in  the  develop¬ 
ment  of  a  sort  of  sixth  sense  for  the  significant  facts  in  their  true 
relation  to  one  another.  It  is  believed  that  a  grasp  of  the  idea  of 
the  main  drift  of  the  family  life  will  keep  the  mind  of  the  worker 
from  staggering  about  among  a  multitude  of  miscellaneous  par¬ 
ticulars,  will  help  it  to  discriminate  between  the  significant  and 
the  insignificant,  and  will  lead  to  a  clearer  diagnosis. 

Another  idea  that  will  help  is  the  concept  of  assets  for  recon¬ 
struction.  The  power  of  family  cohesion  already  mentioned  is 
one  of  the  greatest  of  these.  Somewhat  different  and  equally 
valuable  is  their  capacity  for  affection.  Other  assets  are  capacity 
for  admiration,  for  further  training,  for  more  energetic  endeavor, 
for  enjoyment,  and  for  all-round  social  development.  Nothing, 
however  small,  that  might  serve  as  an  asset  in  the  course  of  treat- 

157 


SOCIAL  DIAGNOSIS 


ment  and  help  to  carry  our  plans  toward  a  successful  issue  can 
possibly  be  insignificant.  Whether  this  be  an  affection  for  a 
small  dog,  an  ambition  to  play  the  accordion,  or  a  lost  or  mislaid 
loyalty,  the  social  physician  must  be  able  to  use,  and  he  must  be 
able  to  recognize  in  order  to  use,  such  tools  as  these  which  lie  ready 
to  his  hand. 


SUMMARY  OF  THIS  CHAPTER 

1.  The  good  results  of  individual  treatment  crumble  away  often  because  the 
case  worker  has  remained  ignorant  of  his  client’s  family  history,  and  has  been  un¬ 
prepared  for  the  sudden  outcropping  of  tendencies  long  hidden. 

2.  ^arly  contacts  with  members  of  the  Family  Group  are  on  a  somewhat  differ¬ 
ent  plane  from  those  with  other  sources  of  information,  because  the  need  of  their 
co-operation  in  treatment  is  usually  greater,  and  further  contacts  are  more  likely  to 
follow. 

3.  The  family  has  a  history  of  its  own  apart  from  the  histories  of  those  who  com¬ 
pose  it.  It  follows  that  a  conception  of  the  main  drift  of  the  family  life  is  very 
necessary  in  any  attempt  to  discriminate  between  the  significant  and  the  insig¬ 
nificant  in  a  mass  of  case  work  data. 

4.  Another  aid  to  clear  thinking  is  the  habit  of  classifying  families  with  reference 
to  their  power  of  cohesion.  The  united  family  “is  able  to  send  its  sons  and  daugh¬ 
ters  far  over  the  face  of  the  earth  without  in  the  least  impairing  the  bond  which 
unites  them.”  In  the  unstable  family  “removal  into  the  next  street”  is  enough 
to  sever  the  bond. 

5.  This  power  of  cohesion  is  only  one  of  the  assets  for  reconstruction  in  family 
case  work.  Others  are  capacity  for  affection,  for  admiration,  for  further  training,  j 
for  more  energetic  endeavor,  for  enjoyment,  and  for  social  development.  Among 
the  children,  more  especially,  the  smallest  signs  of  aptitude,  ambition,  achievement 
are  worth  testing  and  developing.  An  ability  to  discover,  note,  and  use  the  assets 
for  reconstruction  marks  the  true  case  worker* 

6.  Among  the  more  frequent  causes  of  estrangement  between  husband  and  wife 
are  disparity  of  age,  marriage  or  remarriage  foE  economic  reasons,  interference  of 

relatives,  and  differences  in  nationality,  race,  or  religion. 

*  .  \  .  , 

7.  Social  workers  often  ignore  the  husband  and  father  and  deal  exclusively  with 

his  wife  and  children.  He  should  be  seen  and  known.  Especially  important  is 
this  injunction  when  case  workers  are  asked  to  aid  the  families  of  young;  able- 
bodied  men. 

8.  Desertion  and  alcoholism,  like  many  other  social  disabilities,  are  not  so  much 
separate  entities  as  outcroppings  of  more  intimate  aspects  of  the  individual’s  per¬ 
sonal  and  social  life.  Diagnosis  must  lay  a  solid  foundation  for  their  treatment, 
therefore,  by  pushing  beyond  such  “presenting  symptoms”  to  the  complex  of 
causes  farther  back. 


THE  FAMILY  GROUP 


9.  On  the  home’s  physical  side,  three  important  aspects  are  income  and  outgo, 
food  habits,  and  housing.  Most  difficult  of  these  to  gauge  are  the  food  habits, 
which  often  demand  special  study  because  of  their  direct  bearing  upon  health  and 
spending  power. 

10.  The  individualization  of  the  children  in  the  household  must  include  the 
prompt  noting  of  all  variations  from  the  normal  in  their  physical  and  mental  con¬ 
dition. 

11.  The  exact  ages  of  the  children — day,  month,  year  of  birth — have  such  vital 
relation  to  their  adjustment  to  a  number  of  social  laws  and  institutions  that  this 
item  of  fact  should  not  be  omitted. 


CHAPTER  VIII 


OUTSIDE  SOURCES  IN  GENERAL 


REASONS  for  turning  not  only  to  a  client’s  family  group  for 
insight  and  advice  but  to  Outside  Sources  have  been  sug- 
-  gested  earlier.  The  chief  reason  for  seeking  this  further 
help  is  that,  to  beiconstructively  useful,  we  must  be  able  to  break 
through  the  narrow  circle  of  the  client’s  own  view  of  his  situation, 
and  the  narrow  circle  also  of  our  own  prepossessions  and  favorite 
modes  of  procedure.  We  cannot  afford  to  adopt  either  of  these  cir¬ 
cumscribed  boundaries,  because  none  of  us  lives  on  a  desert  island. 

Can  our  client’s  affairs  ever  be  regarded  as  ready  for  social  treat¬ 
ment  when  no  Outside  Sources  have  been  consulted?  Measuring  j 
by  the  standard  of  concrete  result  instead  of  preconceived  theory 
the  answer  would  be  in  the  affirmative.  Cases  studied  for  this  book 
show  correct  diagnoses  that  were  arrived  at  without  any  follow-up 
visits  to  outside  references,  but  they  also  show  a  great  preponder¬ 
ance  of  failures  traceable  directly  to  this  omission.  The  worker 
who  uses  Outride  Sources  freely  has  been  so  trained  by  the  practice 
that  he  can  recognize  when  the  nature  of  the  application  and  of  the 
task  undertaken  makes  consultation  of  the  confidential  exchange 
index1  and  of  the  impersonal  public  records  described  in  the  chapter 
on  Documentary  Sources  the  only  follow-up  work  necessary. 

Always  essential,  though,  is  the  re-examination  of  records  of  the 
individual  case,  both  within  the  agency  applied  to  and  in  the  agen¬ 
cies  revealed  by  the  exchange,  where  there  is  one.  This  re-exami¬ 
nation  should  be  made  just  after  the  first  interview,  and  whenever 
later  a  new  name  comes  to  light,  such  as  a  name  by  a  previous 
marriage. 

Essential  almost  always  is  personal  communication  with  some 
of  those  shown  by  the  records  or  by  the  client’s  story  to  have  known 
him  at  an  earlier  time  and  in  quite  different  ways.  Our  relations 
with  these  Outside  Sources  collectively  and  separately  will  be 


1  See  p.  303  sq. 

160 


OUTSIDE  SOURCES  IN  GENERAL 


sidered  in  this  and  the  eight  chapters  that  immediately  follow.  If 
their  explanations  seem  endlessly  detailed,  it  may  again  be  urged 
in  extenuation  that  this  is  a  punishment  measured  out  to  anyone 
who  attempts  either  to  read  about  one  of  the  practical  arts  or  to 
write  about  it. 


I.  STATISTICS  OF  OUTSIDE  SOURCES 


1.  A  Study  of  the  Sources  Most  in  Use.  Social  workers  have 
been  so  busy  doing  their  work  that  they  have  had  little  time  in 
which  to  formulate  its  processes  or  its  results.  have  been  no 


data  available  as  to  sources  of  information,  for  i 


e,  either  as  to 


those  sources  that  were  consulted  at  all,  or  the  particular 

combinations  of  sources  that  had  been  found  most  valuable  in 
each  different  form  of  social  work.  The  processes  in  which  social 
agencies  are  actually  engaged,  the  things  that  they  are  doing,  are 
often  quite  different  from  what  they  think  they  are  doing.  Accord¬ 
ingly,  a  first,  very  imperfe^attempt  has  been  made  to  get  this 
matter  of  Outside  Sources  ^01  a  basis  of  fact  by  asking  a  variety 
of  social  organizations  to  permit  the  study  of  50  case  records  in 
each,  taking  the  records  chronologically.  -I^Mii^and-private  relief 
departments,  public  and  private  child-placing  and  child-caring 
agencies,  societies  to  protect  children  from  cruelty,  day  nurseries, 
home  and  school  visiting  activities,  juvenile  and  adult  probation 
work,  charity  organization  societies,  and  medical-social  service 
departments  were  among  those  included  in  this  small  piece  of 
research.  Information  from  certain  of  these  social  activities  would, 
in  some  places,  have  had  to  be  very  fragmentary,  because  often 
scant  records  are  kept  or  none  at  all;  but  three  American  cities 
were  chosen,  representing  three  different  stages  of  development  in 
social  work  for  individuals,  and,  in  so  far  as  the  condition  of  their 
social  agency  records  would  permit,  the  forms  of  work  already 
indicated  were  covered  in  each  city.  It  was  possible  to  examine  the 
records  of  19  different  types  of  social  organization.  Each  agency 
seen  was  asked  to  submit  to  special  investigators  the  first  50  new 
case  records  made  at  the  beginning  of  its  last  fiscal  year,1  omitting 

1  In  a  few  instances  the  beginning  of  the  current  year  was  substituted,  and  in  one 
city  the  agencies  filled  out  the  schedules  themselves,  allowing  the  Russell  Sage 
Foundation  investigators  to  compare  these,  however,  with  the  original  records 
later. 


1 1 


l6l 


SOCIAL  DIAGNOSIS 


those  in  which  there  was  no  treatment.  A  transfer  of  the  case  to 
another  agency  after  diagnosis  was  counted  as  a  form  of  treatment. 
No  sources  were  counted  unless  they  had  been  consulted  before  the 
first  important  decision  had  been  made,  as  the  purpose  was  to 
study  the  Outside  Sources  of  information  upon  which  that  decision 
was  based.  “  Important  decision”  was  interpreted  to  mean  some¬ 
thing  more  than  merely  ad  interim  or  emergent  action,  but  was 
interpreted  somewhat  strictly,  nevertheless,  to  avoid  the  kind  of 
temporizing  into  which  too  much  of  our  treatment  drifts.  If  a 
family  applied^:  relief  and  got  it,  or  applied  for  institutional  care 
of  a  child  or  £^pand  got  it,  that  was  an  “important  decision.” 
Members  of  tn^ramily  group,  living  in  the  same  house  with  the 
client  and  having  a  common  table,  were  not  counted  in  this  enu¬ 
meration,  of  course,  and  each  Outside  Source,  whether  an  indi¬ 
vidual  or  an  agency,  was  counted  only  once  in  any  one  case.  As 
“neighbors”  are  sometimes  “friends”  and  “landlords”  sometimes 
“employers,”  each  was  counted  in^e  capacity  in  which  he  was 
the  more  useful.  Items  of  informa^^that  came  not  directly  but 
through  another  responsible  social  agency,  either  in  the  same  city 
or  elsewhere,  were  credited  to  their  true  sources  instead  of  to  the 
agency,  but  were  marked  as  “through  an  intermediary.”  Letters, 
telephone  messages,  telegraphic  dispatches,  and  personal  visits  were 
not  differentiated. 

Institutions  and  agencies,  public  and  private  alike,  were  good 
enough  to  subject  themselves  to  the  repeated  visiting  and  question¬ 
ing  which  even  this  small  study  entailed.  Only  a  few  of  the  tabu¬ 
lated  results  are  germane  to  this  chapter.  Others  will  be  referred 
to  in  the  successive  chapters  on  Outside  Sources,  and  the  more 
detailed  tables  will  be  found  in  Appendix  1 1,  together  with  the  form 
of  schedule  used  in  gathering  the  data. 

In  three  cities,  the  56  social  agencies  whose  records  were  studied 
consulted  10,871  Outside  Sources  before  making  their  first  impor¬ 
tant  treatment  decision  in  2,800  cases  (50  studied  for  each  agency). 
This  was  an  average  of  3.88  Outside  Sources  per  case,  but  a  figure 
which  covers  such  varied  types  of  work  as  have  already  been  de¬ 
scribed  can  mean  very  little.1  It  is  only  in  comparing  task  with 

1  These  services  were,  in  detail,  as  follows:  Giving  material  relief,  making  loans, 
procuring  employment,  day  nursery  care,  other  provision  for  dependent  children, 

162 


OUTSIDE  SOURCES  IN  GENERAL 


task,  source  with  source,  and  city  with  city  that  the  figures  have 
any  significance,  and  it  would  be  easy  to  exaggerate  the  importance 
of  these  comparisons. 

There  is  danger  in  dogmatizing  about  the  relative  value  of 
sources  and  about  the  number  of  sources  consulted.  In  work  with 
individuals  averages  mean  very  little.  As  one  institution  worker 
protested,  “A  foundling  picked  up  on  the  steps  of  the  city  hall 
hasn’t  many  references,  you  know.”1  In  some  cases  three  Outside 
Sources  might  be  too  many  to  consult,  in  others  thirty  sources 
might  be  too  few;  there  must  be  wide  variation,  according  to 
the  nature  of  the  task  undertaken  and  the  story  developed  in 
the  first  interview.  But  the  preparation  of  these  statistics  and  all 
the  other  case  reading  undertaken  for  this  volume  point  to  many 
more  errors  of  omission  than  commission  in  the  matter  of  outside 
inquiry.  Social  workers  in  the  United  States  are  not  overinvesti¬ 
gating;  at  present  they  are  underinvest i gating,  though  the  tables 
of  Appendix  II  show  that  some  of  them  have  discovered  and  are 
using  a  wide  range  of  sources  not  yet  utilized  by  the  others. 

Other  things  being  equal,  the  social  worker  who,  in  addition  to 
the  sources  that  are  almost  universally  valuable,  consults  the  most 
diverse  sources  of  information  for  diverse  tasks  and  diverse  cases, 
is  doing  the  best  work.  Such  breaking  through  routine  brings  new 
sources  to  light,  but  a  certain  routine  must  first  be  mastered  before 
it  is  safe  or  wise  to  attempt  to  be  original.  And  after  a  routine  has 
been  mastered,  it  should  be  criticized  and  revised  at  frequent  inter¬ 
vals.  The  schedule  used  in  this  study2  can  be  turned  to  account 
in  the  criticism  of  daily  procedure.  Its  first  draft  was  tried  out  by 
the  writer  with  a  small  group  of  inexperienced  case  workers  in 
Philadelphia  years  ago.  It  revealed  that  they  were  neglecting 
“trade  unions”  and  “fellow  workmen”  habitually  as  sources  of 
insight  and  co-operation,  and  that  they  were  covering  the  physical 
history  of  the  children  under  their  care  far  more  completely  than 

advice  on  school  matters,  rescue  of  children  from  neglect,  correction  of  juvenile 
delinquency,  medical  advice,  medical  care,  provision  for  defectives,  institutional 
care  of  adults,  adult  probation,  advice  on  family  problems. 

1  A  critic  informs  the  writer,  however,  that  the  Board  of  Children’s  Guardians 
in  St.  Louis  has  reduced  the  number  of  foundlings  housed  at  city  expense  over  half 
by  investigations  recently  made.  The  hospital  where  a  foundling  was  born  has 
proved  a  good  starting  point  for  “references.” 

2  See  Appendix  1 1. 


163 


SOCIAL  DIAGNOSIS 


their  school  record.  In  discovering  our  weak  points,  such  devices 
have  a  definite  use;  they  serve  also  to  show  how  even  a  strong  point 
may  be  overemphasized  until  it  becomes  a  weak  one.  We  become 
superstitious,  sometimes,  about  a  favorite  source  or  form  of  inquiry. 

2.  Nature  of  Sources.  A  certain  routine  must  be  mastered; 
it  will  help  in  forming  our  own  standard  for  a  given  form  of  child¬ 
saving  or  family  or  medical-social  work  to  discover  what  sources 
are  most  frequently  used  by  representative  agencies  in  each  of 
these  classes — by  agencies,  that  is,  which  appear  to  have  a  high 
standard  of  treatment;  and  it  will  even  help  to  discover  what 
sources  are  most  used  by  those  that  have  a  low  standard.  All  the 
data  gathered  are  quantitative  not  qualitative,  be  it  remembered, 
except  in  so  far  as  the  habitual  use  of  a  source  discredited  by  the 
experience  of  good  social  diagnosticians — such  a  source  as  present 
neighbors,  for  instance — or  the  habitual  use  of  the  same  two  or 
three  sources  and  no  more,  gives  a  sidelight  upon  quality.  It  was 
suggested  that  the  schedule  contain  two  additional  columns — one 
to  indicate  the  usefulness  of  the  information  secured,  and  the  other 
to  show  whether  the  person  or  agency  consulted  had  shared  in  the 
treatment  later,  but  this  seemed  impracticable.  In  judging  values 
as  between  one  relative’s  advice  and  another’s,  we  drift  easily  into 
the  realm  of  individual  opinion,  but  whether  both  relatives  had 
been  consulted  at  all  is  not  a  matter  of  opinion. 

Quantitatively,  then,  we  find  that — omitting  social  agencies 
from  the  computation1 — the  20  Outside  Sources  most  used  by  all 
the  agencies  in  each  of  the  cities  stand,  in  order  of  frequency,  as 
shown  on  the  opposite  page. 

The  failure  in  two  of  the  cities  to  consult  public  records  of  mar¬ 
riage,  and  in  one  city  records  of  birth,  is  a  sign  of  weakness  in 
technique.  In  the  first  city,  these  stand  eleventh  and  twelfth  in 
the  list  of  sources.  Another  indicated  practice  the  wisdom  of  which 
has  already  been  challenged  is  the  frequent  use  of  sources  belong¬ 
ing  to  the  present  neighborhood.  In  the  third  city  “present 

1  The  reasons  for  considering  social  agencies  separately  are  given  in  Chapter 
XVI,  Social  Agencies  as  Sources  (p.  297).  The  term  “social  agencies”  includes  church 
sources,  private  agencies  (family  agencies,  homes  for  adults,  homes  for  children, 
S.  P.  C.  C’s,  children’s  aid  societies,  day  nurseries,  settlements),  public  agencies 
(charities  or  public  outdoor  relief  departments,  adult  and  juvenile  probation  depart¬ 
ments,  municipal  lodging  houses,  almshouses),  etc. 

164 


a  Exclusive  of  public  and  private  charitable  and  social  agencies. 
b  Only  the  first  consultation  with  each  source  used  was  counted  in  any  case. 
c  The  term  “landlord”  is  used  to  cover  the  owner,  agent,  and  janitor. 

d  In  the  third  city,  district  or  county  attorneys  were  consulted  the  same  number  of  times  as  present  tradesmen. 


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l65 


TABLE  I. — TWENTY  SOURCES21  MOST  USED  IN  THREE  CITIES,  IN  ORDER  OF  FREQUENCY  OF  USE 


SOCIAL  DIAGNOSIS 


TABLE  2. — ORDER  OF  FREQUENCY  OF  CONSULTATION  IN  THE  SEPA¬ 
RATE  CITIES  OF  THE  20  SOURCES21  MOST  OFTEN  USED  IN  THE 
THREE  CITIES  TAKEN  TOGETHER13 


Order  of 
frequency 
of  use  in 
the  three 
cities 

Source 

Order  of  frequency  of  consultation  in  the 

First  city 

Second  city 

Third  city 

1 

Relatives 

1 

1 

4 

2 

Present  neighbors 

9 

3 

1 

3 

Physicians 

2 

9 

3 

4 

Friends 

6 

6 

2 

5 

Former  employers 

5 

7 

6 

6 

Hospitals  and  sanatoria 

4 

8 

10 

7 

Teachers  and  principals 

7 

2 

i7g 

8, 

Clergymen 

8 

1 1 

8 

9 

Present  landlords 

18 

4 

5 

10 

Present  employers 

10 

10 

9 

1 1 

Former  landlords 

16 

5 

16 

12 

Police 

3 

17 

i8g 

•3 

Dispensaries 

14 

14 

12 

14 

Former  neighbors 

>3 

I2d 

15 

15 

Courts 

17 

13d 

14 

16 

Nurses 

19 

2  Ie 

19s 

17 

Health  departments 

20 

16 

28b 

18 

Lawyers 

2  ic 

25f 

22 

19 

Present  tradesmen 

29 

24 

20* 

20 

Fellow  church  members 

22c 

39 

13 

a  Exclusive  of  private  and  public  charitable  and  social  agencies. 

b  The  20  sources  most  used  in  the  three  cities  taken  together  were  selected  as 
follows:  For  each  city  all  the  sources  were  numbered  in  order  of  frequency  of  con¬ 
sultation,  beginning  with  the  source  most  frequently  consulted.  The  numbers 
indicating  the  order  of  frequency  of  each  source  in  the  three  cities  were  then  added 
together.  The  20  sources  showing  the  smallest  resulting  totals  are  included  in  the 
table. 

c  Same  number  of  consultations  with  lawyers  and  with  fellow  church  members, 
in  records  of  first  city. 

d  Same  number  of  consultations  with  former  neighbors  and  with  courts,  in 
records  of  second  city. 

e  Truant  officers  were  consulted  same  number  of  times  as  nurses,  in  records  of 
second  city. 

f  Lodgers  were  consulted  same  number  of  times  as  lawyers,  in  records  of  second 
city. 

g  Same  number  of  consultations  With  teachers,  with  police,  and  with  nurses  in 
records  of  third  city. 

h  Former  tradesmen  and  foreign  consuls  were  consulted  same  number  of  times 
as  health  departments,  in  records  of  third  city. 

1  District  or  county  attorneys  were  consulted  same  number  of  times  as  present 
tradesmen,  in  records  of  third  city. 


OUTSIDE  SOURCES  IN  GENERAL 


neighbors”  actually  heads  the  list  of  sources,  and  it  stands  third 
in  the  second  city ;  “  present  ”  and  “  former  landlords  ”  in  the  second 
city  and  “present  landlords”  in  the  third  are  also  used  very  fre¬ 
quently.  The  significance  of  these  differences  in  practice  as  be¬ 
tween  the  first  and  the  second  and  third  cities,  and  the  serious  dan¬ 
gers  involved  in  the  use  of  neighborhood  sources  at  all  are  brought 
out  in  the  chapter  on  Neighborhood  Sources.  Another  difference 
is  in  the  use  of  “policemen,”  which  may  be  accounted  for  by  the 
fact  that  no  study  of  probation  work,  either  adult  or  juvenile,  was 
possible  in  the  second  and  third  cities,  while  in  the  first  city  both 
of  these  and  a  number  of  other  forms  of  work  in  which  the  evidence 
of  the  police  would  be  important  were  included.  The  marked  differ¬ 
ences  in  the  use  of  “teachers”  may  be  accounted  for  by  the  fact 
that  the  proportion  of  agencies  studied  which  dealt  exclusively  with 
children  was  smallest  in  the  third  city  and  largest  in  the  second. 

But  when  we  consider  that  social  case  work  in  these  many  forms 
and  these  different  places  has  not  been  developed  out  of  any  for¬ 
mulated  and  systematically  transmitted  experience,  for  the  most 
part,  but  has  felt  its  way  quite  independently,  often,  to  processes  that 
grew  out  of  the  necessities  of  the  day’s  work,  we  shall  find  the  re¬ 
semblances  in  practice  as  shown  in  these  statistics  quite  as  striking 
as  the  differences,  especially  if  we  compare  the  larger  groupings 
of  sources  shown  in  the  large  general  Table  A  in  Appendix  II. 
Here  the  fact  stands  out  that,  with  many  variations  within  each 
group  and  variations  as  between  groups  allowed  for,  there  still  has 
been  frequent  use  in  all  three  cities  of  the  sources  classified  under 
social  agencies  and  churches,  doctors  and  health  agencies,  former 
and  present  neighborhoods,  relatives,  former  and  present  employers, 
schools,  friends,  and  public  records. 

As  to  the  shifting  of  emphasis  upon  one  or  another  of  these,  as 
we  change  from  family  work  to  children’s  work,  from  one  form  of 
children’s  work  to  another,  or  from  all  to  medical-social  service,  the 
figures  show  some  interesting  variations.  Table  B  in  Appendix  1 1 
tells  the  story  in  detail.  Its  most  important  features  are  brought 
out  in  Tables  3  and  4  on  the  pages  immediately  following. 

The  first  city  was  chosen  for  making  this  particular  comparison 
because  it  was  the  only  one  of  the  three  (at  the  time  the  study  was 
made  at  least)  in  which  the  standard  of  treatment  was  quite  as 

167 


SOCIAL  DIAGNOSIS 


TABLE  3. — TWENTY  SOURCESa  MOST  USED  BY  AGENCIES  DOING 
WORK  WITH  CHILDREN,  FAMILY  WORK,  AND  MEDICAL-SOCIAL 
WORK  IN  FIRST  CITY,  IN  ORDER  OF  FREQUENCY  OF  USE 


Order 
of  fre¬ 
quency 
of  use 

Work  with  children 
(10  agencies) 

Family  work 
(5  agencies) 

Medical-social  work 
(3  agencies) 

1 

Relatives 

Relatives 

Physicians 

2 

Police 

Hospitals  and  sanatoria 

Hospitals  and  sanatoria 

3 

Physicians 

Physicians 

Relatives 

4 

Teachers 

Former  employers 

Former  employers 

5 

Former  employers 

Clergymen 

Present  neighbors 

6 

Clergymen 

Friends 

Nurses 

7 

Friends 

Dispensaries 

Teachers 

8 

Birth  records 

Teachersd 

Clergymen 

9 

Present  neighbors15 

Marriage  records^ 

Friends 

10 

Courts*5 

Fellow  church  members 

Present  landlords 

1 1 

Hospitals  and  sanatoria 

Present  employers 

Medical  inspectors 

12 

Marriage  records 

Present  landlords 

Present  employers* 

13 

Former  neighbors 

Present  neighbors 

Health  departments* 

14 

Former  landlords 

Medical-social  service 
departments 

Dispensaries 

15 

Present  employers 

Former  landlords 

Former  neighborsg 

16 

Health  departments 

Former  neighbors 

Marriage  recordsg 

17 

Lawyers 

Nurses 

Lawyersg 

18 

Present  landlords0 

Police 

Medical-social  service 
departments*1 

19 

Nurses0 

Present  tradesmen 

Police*1 

20 

Medical-social  service 
departments 

Truant  officers6 

Birth  records1 

a  Exclusive  of  public  and  private  charitable  and  social  agencies. 
b  Same  number  of  consultations  with  courts  as  with  present  neighbors,  in 
records  of  work  with  children. 

c  Same  number  of  consultations  with  nurses  as  with  present  landlords,  in 
records  of  work  with  children. 

d  Same  number  of  consultations  with  marriage  records  as  with  teachers,  in 
records  of  family  work. 

e  Same  number  of  consultations  with  prison  and  reformatory  officials  as  with 
truant  officers,  in  records  of  family  work. 

f  Same  number  of  consultations  with  health  departments  as  with  present  em¬ 
ployers,  in  records  of  medical-social  work. 

g  Same  number  of  consultations  with  marriage  records  and  lawyers  as  with 
former  neighbors,  in  records  of  medical-social  work. 

h  Same  number  of  consultations  .with  police  as  with  medical-social  service 
departments,  in  records  of  medical-social  work. 

1  Same  number  of  consultations  with  a  number  of  other  sources  as  with  birth 
records,  in  records  of  medical-social  work. 

high  in  children's  work  as  in  family  work,  and  in  which  medical- 
social  work  could  safely  be  compared  with  both.  The  figures  for 

168 


OUTSIDE  SOURCES  IN  GENERAL 


TABLE  4. — USE  OF  THE  20  SOURCESa  MOST  USED  IN  THE  FIRST  CITY, 
BY  AGENCIES  DOING  WORK  WITH  CHILDREN,  FAMILY  WORK,  AND 
MEDICAL-SOCIAL  WORK  IN  THAT  CITY 


Source 

Number  of  consultations13  with  each 
source,  per  50  cases 

Work  with 
children 
(10  agencies) 

Family  work 
(5  agencies) 

Medical- 
social  work 
(3  agencies) 

Relatives 

42.4 

39.2 

13.3 

Physicians 

18.9 

20.6 

53.0 

Police 

22.9 

4.8 

1.0 

Hospitals  and  sanatoria 

8.7 

23.4 

26.7 

Former  employers 

13.6 

18.6 

5-3 

Friends 

12.4 

13.4 

3-3 

Teachers,  etc. 

15.0 

9.6 

4-3 

Clergymen 

13.0 

18.0 

3-7 

Present  neighbors 

8.9 

7.0 

5.0 

Present  employers 

6.4 

7.6 

2.0 

Marriage  records 

8.3 

9.6 

i-3 

Birth  records 

1 1.6 

3.6 

•7 

Former  neighbors 

8.0 

5.6 

J-3 

Dispensaries 

2.0 

10.8 

i-7 

Medical-social  service  departments 

3-5 

6.8 

1.0 

Former  landlords 

7-i 

6.4 

•  •  • 

Courts 

8.9 

1.6 

•7 

Present  landlords 

3.8 

7-4 

3.0 

Nurses 

3.8 

5-4 

4-7 

Health  departments 

4.6 

2.8 

2.0 

a  Exclusive  of  social  and  charitable  agencies,  public  and  private. 
b  Only  the  first  consultation  with  each  source  used  was  counted,  in  any  one  case. 


each  separate  agency  in  the  first  city  are  given  in  Table  B  in  Appen¬ 
dix  II,  thus  making  it  possible  for  a  student  interested  in  forms  of 
organization  to  compare  the  classifications  in  greater  detail. 

II.  PRINCIPLES  GOVERNING  THE  CHOICE  OF  SOURCES 
After  a  social  organization  has  abandoned  the  old  idea  that  a 
more  or  less  searching  cross-examination  of  one  witness  (of  the 
client,  that  is)  is  an  adequate  basis  for  action — even  after  it  has 
advanced  beyond  this  stage,  its  earlier  adventures  in  social  diag¬ 
nosis  are  likely  to  bring  endless  variations  on  the  theme  of  the 
client’s  present  situation.  It  will  hear  this  described  again  and 
again  by  charitable  individuals  and  social  workers,  and  will  assume 

169 


SOCIAL  DIAGNOSIS 


that,  in  listening  to  these  detailed  statements,  it  is  gathering  valu¬ 
able  diagnostic  material.  “All  these  people/’  said  one  critic  after 
examining  a  group  of  case  records,  “  seem  to  have  been  born  just 
about  two  years  ago.  There  is  a  great  deal  set  down  about  what 
they  and  the  charities  have  done  since,  but  they  have  no  past.” 

1.  First  Principle  of  Choice.  When,  the  first  interview  over 
and  a  home  visit  paid,  we  find  ourselves  with  a  group  of  clues,  per¬ 
haps  the  most  important  principle  of  action  is  to  strike  out  boldly 
for  history  and  avoid,  for  the  time  being  at  least,  thbse  references 
whose  point  of  view  is  most  like  our  own.  Where  there  has  been 
an  investigation  already,  we  should  profit  by  it,  of  course,  but 
where  there  has  not,  we  cannot  afford  to  lose  a  moment  before  con¬ 
sulting  the  people  who  knew  our  client  at  his  best,  if  he  ever  had 
a  best;  who  knew  him  at  least  at  other  times  and  in  other  relations. 
These  can  give,  one  from  this  angle,  one  from  that,  the  aspects  that 
will  help  us  to  see  our  subject  in  the  round.  Any  notion  of  social 
efficiency  that  excludes  the  humblest  sources  of  knowledge  and 
help  makes  for  inefficiency  in  the  long  run.  Too  often  we  confer 
with  the  sources  that  are  nearest  to  us,  and  neglect  those  that  are 
nearest  to  our  client.  Other  things  being  equal,  the  evidence  of 
those  who  knew  him  before  the  present  difficulties  developed  is 
worth  ten  times  as  much  as  the  evidence  of  those  who  have  known 
him  since.  But  this  must  not  be  construed  as  referring  to  length 
of  acquaintance,  merely.  We  can  know  people  a  long  time  and 
really  know  them  very  little.1  The  nature  of  the  relation  and  the 
opportunities  that  it  has  given  for  self-expression  are  the  important 
things. 

2.  Second  Principle  of  Choice.  In  order  that  we  may  never 
have  to  pay  two  visits  where  one  can  be  made  to  serve,  a  second 
principle  will  be  found  useful  in  making  our  choice  of  diagnostic 
sources,  and  in  preparing,  at  the  same  time,  for  the  co-operation 
which  will  probably  be  needed  later  in  treatment.  This  principle 
is  to  seek  first  those  sources  that  are  likely  to  be  rich  in  history  only 
and  seek  later  those  most  likely  to  be  rich  also  in  co-operation. 
It  is  wise  to  build  in  our  background  and  get  as  clear  a  picture  of 

1  Dr.  S.  Weir  Mitchell  says  of  the  family  doctor,  who  belongs  to  this  long- 
acquaintance  group,  “  He  is  supposed  to  have  some  mysterious  knowledge  of  your 
constitution,  and  yet  may  not  have  asked  you  a  medical  question  in  months  and 
years.” — Doctor  and  Patient,  p.  28. 

170 


OUTSIDE  SOURCES  IN  GENERAL 


our  foreground  as  can  be  had  before  consultation  is  attempted  with 
those  upon  whose  co-operation  we  must  depend  for  the  success  of 
our  plan,  and  in  part,  perhaps,  for  its  shaping.  Some  social  workers 
invariably  see  the  relatives  first,  others  the  employers,  and  others 
the  doctors.  Such  rules  save  the  trouble  of  thinking,  but  a  more 
flexible  method  is  to  let  the  order  of  seeing  Outside  Sources  grow 
naturally  out  of  the  individual  circumstances,  having  in  mind,  how¬ 
ever,  the  need  of  developing  history  first,  and  then,  on  the  basis  thus 
revealed,  co-operation. 

It  is  true  that  the  yield  in  neither  history  nor  co-operation  can 
be  accurately  gauged  in  advance,  but  our  conduct  of  the  first  inter¬ 
view  should  have  helped  us  to  some  inferences.  If  we  go  to  the 
people  whose  co-operation  is  likely  to  be  valuable  but  whose  knowl¬ 
edge  is  either  biased  or  incomplete,  at  a  time  when  we  know  little 
ourselves,  we  are  in  grave  danger  of  launching  them  and  of  being 
launched  upon  a  plan  of  action  that  must  be  modified  almost 
immediately.  They  may  easily  resent  any  attempt  at  modification 
under  such  circumstances,  and  not  only  will  time  have  been  wasted 
for  our  client  and  ourselves,  but  co-operative  relations  will  have 
been  weakened  by  the  false  start. 

One  difficulty  in  applying  this  principle  of  choice  will  be  with 
relatives,  some  of  whom — we  cannot  always  know  which  ones — 
may  be  rich  in  co-operation  and  all  of  whom  are  familiar  with  cer¬ 
tain  details  of  the  early  background.  Though  relatives  are  rich 
in  history  unquestionably,  the  fact  that  this  is  true  of  all  of  them 
may  enable  us,  with  the  help  of  such  hints  as  we  get  from  our  client’s 
story,  to  apply  the  distinction  implied  in  the  principle;  we  can  see 
first  the  relatives  least  likely  to  be  able  to  co-operate  actively,  and 
later  those  most  likely  to  do  so.  Many  accidental  things  will  prob¬ 
ably  interfere  with  a  strict  following  of  this  principle,  however.  The 
distances  to  be  covered,  the  hours  at  which  people  can  be  seen,  the 
need  of  unusually  prompt  action  are  only  a  few  of  the  conditions 
which  will  necessarily  modify  the  order  in  which  Outside  Sources 
can  be  consulted  in  the  daily  pressure  of  case  work. 

The  two  principles  of  action  here  explained  are  well  illustrated  by  an  investiga¬ 
tion  of  a  widow’s  family,  though  the  social  worker  who  made  it  was  quite  uncon¬ 
scious,  probably,  of  the  mental  processes  by  which  she  arrived-.at  a  good  order  of 
visits. 

171 


SOCIAL  DIAGNOSIS 


The  application  was  made  by  the  widow’s  sister — a  servant  whose  employer 
wrote  to  a  charity  organization  society.  The  first  interview  with  the  widow  brought 
the  addresses  of  the  following:  Another  sister  and  an  aunt  of  hers;  a  brother  and 
an  aunt  of  her  husband’s;  the  family  doctor;  the  hospital  where  her  husband  had 
died;  the  Catholic  church  of  the  parish  in  which  she  had  been  living  for  a  few 
months;  the  Catholic  church  of  the  parish  in  which  she  had  lived  for  many  years; 
and  the  Presbyterian  church  in  this  former  neighborhood.  Her  husband  had  been 
a  Protestant,  and  the  children  had  attended  the  Presbyterian  Sunday  school  during 
his  lifetime. 

The  widow’s  only  resources  were  help  from  the  St.  Vincent  de  Paul  Council  of  the 
new  parish,  and  from  the  sister  who  was  at  service.  There  were  five  children  under 
twelve  years  of  age  to  be  cared  for.  Many  workers  would  have  gone  to  the  present 
priest  and  to  the  servant  girl  sister  at  once,  as  the  two  people  most  practically 
interested.  The  sister  knew  the  past  history  as  well  as  any  one  person  could  know 
it,  probably,  but  the  worker  first  took  the  trolley  car  for  a  six-mile  journey  to  the 
old  neighborhood,  saw  the  grocer  with  whom  the  family  had  traded  before  the  man’s 
death,  visited  the  priest  who  had  known  the  wife  for  years,  the  doctor  who  had 
attended  them  in  their  old  home,  and  the  principal  of  the  school  that  the  children 
formerly  attended.  Her  next  journey  was  to  the  home  of  the  husband’s  brother 
and  to  his  aunt,  then  to  a  politician  who  was  said  to  have  helped  the  family  very 
lavishly,  then  to  the  Presbyterian  church  visitor  who  was  reported  to  have  been 
helping  at  the  same  time  that  the  Catholic  church  helped.  Both  of  these  reports 
were  disproved  at  once,  so  that  they  could  not  come  up  later  in  a  way  that  would 
disturb  the  course  of  treatment.  Then  and  only  then  were  the  widow’s  own  rela¬ 
tives  and  her  parish  priest  turned  to — not,  of  course,  with  a  view  to  dictating  to 
them  the  plan  of  action  that  they  should  pursue,  but  with  a  desire  to  hear  every¬ 
thing  that  they  had  to  say  and  then,  in  the  same  interview,  to  confer  with  them  as 
to  what  permanent  plan  could  be  made  for  the  widow’s  benefit,  and  what  share 
each  could  bear  in  its  carrying  out. 

The  new  priest  hardly  knew  the  widow;  the  servant  sister  was  bent  upon  giving 
her  whatever  character  would  most  promptly  secure  material  help.  But  earlier 
inquiries  had  reconstructed  the  normal  life  in  the  old  neighborhood  and  had  sifted 
the  prejudiced  gossip  of  the  deceased  husband’s  people,  leaving,  it  is  true,  some 
weaknesses  to  be  guarded  against,  but  making  it  clear  that  here  was  a  home  worth 
keeping  together  and  a  plan  needed  that  would  give  the  mother  something  definite 
to  count  upon  until  the  children  were  earning.  The  plan  decided  upon  in  the  first 
visits  to  the  parish  priest  and  to  the  sister  included  a  regular  allowance  plus  half  the 
rent  from  the  sister  at  service.  The  church  bore  a  share  in  this  plan,  which,  with 
slight  modifications,  was  continued  through  a  series  of  years. 

_ 

3.  Third  Principle  of  Choice.  The  foregoing  principles  may  be 
greatly  strengthened  by  careful  observance  of  a  third,  which  is  that 
we  must  seek  out  the  witnesses  who  have^been'  able  io  make  first¬ 
hand  observations  in  preference  to  those  whose^-information  is  at 
second-hand.  In  other  words,  we  must -beware  of  multiplying  wit- 


OUTSIDE  SOURCES  IN  GENERAL 


nesses  without  getting  new  observations.  This  matter  was  touched 
upon  in  Part  I,  where  Langlois  was  quoted  with  regard  to  the  three 
chroniclers  who  agreed  so  admirably  because  their  parallel  accounts 
were  all  derived  from  one  source;1  but  it  deserves  especial  emphasis 
and  further  illustration  in  connection  with  this  division  of  our 
subject.  There  are  few  commoner  errors  and  few  that  work  greater 
havoc  in  social  case  work  than  the  use  of  items  of  hearsay  evidence 
without  any  consciousness  of  their  hearsay  nature. 

Let  the  treatment  of  one  unfortunate  case  illustrate  both  the  need  of  past  history 
and  the  danger  of  multiplying  statements  without  multiplying  observations.  A 
charity  organization  society  was  responsible.  The  head  resident  of  a  church  settle¬ 
ment  referred  Mrs.  O,  a  German  widow  with  four  children  and  “well  known  to  me 
as  a  worthy,  respectable  woman.”  A  first  interview  brought  the  following  items: 
that  the  youngest  child,  a  boy  aged  three  and  a  half  years,  was  blind;  that 
the  oldest  girl,  aged  eleven,  could  neither  read  nor  write,  and  that  none  of  the 
children  were  going  to  school;  that  the  husband  had  not  died  but  had  deserted,  ac¬ 
cording  to  the  wife,  three  years  ago;  that  they  had  come  to  America  and  this  par¬ 
ticular  city  eleven  years  back;  that  he  had  no  relatives  living  and  hers  were  all  in 
Germany;  and  that  he  had  formerly  worked  at  the  shot  works,  while  she  had  been 
employed  by  certain  stores  and  householders.  A  few  former  addresses  were  given, 
but  some  of  them  rather  indefinitely.  “Left  a  dollar  to  expend  on  coal  and  food 
as  there  was  almost  nothing  to  eat.  Mrs.  O  took  it  rather  reluctantly.  Seemed 
almost  hurt  when  it  was  offered  to  her.  Told  her  she  could  consider  it  as  a  loan  if 
she  wanted  and  pay  it  back  when  she  could.” 

On  the  doorstep  after  the  close  of  the  interview,  what  clues  did  the  social  worker 
hold  in  her  hand?  There  were  three  previous  addresses  that  were  indefinite  but 
that  might  have  been  made  less  so  with  the  aid  of  a  set  of  city  directories,2  and  a 
definite  previous  address  on  the  waterfront  where  the  woman  had  lived  until  a  few 
months  ago;  there  was  a  firm  in  town  and  one  out  of  town  for  whom  the  man  was 
said  to  have  worked;  and  there  were  the  woman’s  work  references  before  her  hus¬ 
band’s  departure,  and  the  addresses  of  two  housewives  for  whom  she  had  done  day’s 
work  since.  The  worker  went  first,  however,  to  the  settlement  house  that  had  re¬ 
ferred  the  client  for  treatment.  Here  Mrs.  O  had  been  known  for  a  year  and  a 
half.  It  was  learned  from  another  worker  than  the  one  who  had  written  that  Mr. 
0  had  deserted  three  years  before  and  had  not  been  heard  from  since,  and  that  his 
wife  was  very  proud,  industrious,  and  hard-working.  If  the  settlement  workers 
had  known  Mrs.  O  only  a  year  and  a  half,  they  were  not  competent  witnesses  as  to 
the  desertion,  and  “very  proud”  doe?  not  describe  Mrs.  O  as  well  as  would  a  plain 
statement  of  the  acts  upon  which  this  judgment  was  based.  The  worker  next 
visited  two  housewives  of  -the  neighborhood  for  whom  Mrs.  O  had  done  day’s 
work.  Both  gave  much  the  same  evidence — she  was  honest,  industrious,  hard-work- 

1  See  p.  57. 

2  See  Chapter  XIII;  Documentary  Sources. 

173 


SOCIAL  DIAGNOSIS 


ing.  Next,  a  letter  was  dispatched  to  Germany  asking  the  public  charities  to  see 
Mrs.  O’s  mother,  to  “present  to  her  the  following  facts”  (namely,  the  desertion  and 
the  present  pitiful  condition),  and  to  ask  her  whether  she  would  take  her  daughter 
back  and  care  for  the  children,  or  what  she  would  advise.  This  letter  brought  a 
perfunctory  reply  of  “not  able  to  help”  and  no  more.  But  meanwhile,  without 
further  visits  to  possible  Outside  Sources,  though  with  repeated  visits  to  Mrs.  O 
herself,  the  society  had  launched  out  upon  a  plan  of  adequate  regular  allowance 
for  the  family,  the  girl  and  the  other  children  to  be  sent  regularly  to  school,  the 
youngest  child  to  be  entered  at  the  institute  for  the  blind,  etc. 

This  plan  assumed  the  hearty  co-operation  of  the  mother,  and  the  absence  of 
any  different  and  irreconcilable  plans  in  her  own  mind.  Little  things  happened 
that  might  have  shaken  their  faith  in  her  singleness  of  purpose,  such  as  finding  the 
girl  out  after  dark  gathering  scraps  of  cold  food,  many  small  excuses  for  not  keeping 
appointments,  and  removal  without  consultation  back  to  the  old  neighborhood  that 
had  never  been  investigated;  but  the  social  worker  was  so  sure  of  her  own  first  im¬ 
pressions,  re-enforced  as  they  had  been  by  three  other  impressions  of  the  same  kind, 
that,  when  it  was  found  that  a  man  had  been  boarding  at  Mrs.  O’s,  her  own  strong 
protestations  of  innocence  were  treated  as  more  than  offsetting  the  neighborhood 
gossip;  the  man  withdrew  and  the  allowance  was  continued.  But,  as  time  went 
on,  nothing  happened  to  the  children  that  the  society  intended  to  have  happen. 
It  had  been  and  continued  to  be  earnest  in  its  efforts,  but  the  girl  was  still  not  in 
school  after  repeated  placings.  (The  neighborhood  was  a  crowded  one,  and  the 
school  authorities  had  no  abundance  of  school  sittings,  so  that  escape  on  the  official 
side  was  easy.)  The  blind  child  had  never  been  allowed  by  his  mother  to  go  to  the 
special  institution  willing  to  receive  him,  or  to  have  proper  medical  care  outside; 
his  condition  at  the  end  of  his  sixth  year  was  so  pitiable  as  to  excite  the  interest  of 
many  charitable  people,  the  children  were  begging  frequently,  and,  at  last,  the  im¬ 
pressionable  and  kindly  friends  of  the  family  are  found  clamoring  at  the  offices  of 
the  S.  P.  C.  C.,  claiming  that  these  children  are  being  used  to  secure  support  for  an 
immoral  mother  and  must  be  taken  immediately  from  a  woman  about  whom  the 
complainants  know  very  little  but  are  forced  to  conjecture  much. 

Not  to  judge  her  or  condemn  her,  for  Mrs.  O’s  shortcomings  could  not  have 
seemed  so  bad  if  her  past  had  explained  them,  but  just  to  know  and  help  her  if 
they  could,  and  to  protect  at  all  hazards  those  four  children,  whose  future  still 
stretched  so  far  ahead,  the  charity  organization  society  should  have  had  at  the  very 
beginning  a  clear  picture  of  the  O  family  at  its  best,  before  charitable  ladies  had 
made  its  acquaintance.  There  were  Outside  Sources  of  information  to  reveal  this 
picture  in  part,  and  some  of  these  would  have  furnished  clues  to  others.  As  to  the 
slight  evidence  that  was  gathered  from  the  settlement  and  the  housewives,  only 
those  to  whom  all  statements  are  of  equal  value  could  have  regarded  this  as  evidence 
at  all. 

4.  Fourth  Principle  of  Choice.  Another  principle  to  bear  in 

mind  is  that  we  must  recognise  the  special  value  of  supplementary 
clues — of  clues,  that  is,  to  sources  of  information  not  revealed  in  the 

174 


OUTSIDE  SOURCES  IN  GENERAL 


first  interview  or  in  subsequent  ones  with  the  family  group,  but  which 
come  to  light  in  the  course  of  inquiry.  A  source  revealed  casually  is 
less  likely  to  be  prejudiced.  In  the  protection  of  children  from 
cruelty  this  distinction  of  the  supplementary  clue  is  clearly  made, 
owing  to  the  need  of  legal  evidence,  but  it  is  a  distinction  that 
might  have  been  useful  in  the  case  just  cited,  and  that  might  have 
helped,  in  combination  with  other  elements  of  a  sound  technique, 
to  render  the  intervention  of  the  society  to  protect  children  un¬ 
necessary. 

5.  Fifth,  Sixth,  and  Seventh  Principles  of  Choice.  Francis  H. 
McLean  suggests  three  principles  of  choice  which  should  be  added 
to  the  four  already  named : 

(5)  We  should  see  someone  belonging  to  each  of  the  groups  able 
to  view  the  client  and  the  family  from  a  different  angle.  Two  such 
groups  are  the  relatives  on  the  husband’s  side  and  the  relatives  on 
the  wife’s  side.  If  there  is  not  time  or  if  it  seems  unwise  for  other 
reasons  to  see  all  relatives,  then  some  on  each  side  of  the  house 
should  be  seen.1  In  other  words,  we  should  think  of  sources  in 
groups,  and  tap  each  group  for  a  new  set  of  experiences . 

(6)  Some  groups  of  sources  may  be  called  one-headed  groups,  in 
that  all  constituting  the  group  are  likely  to  see  eye  to  eye  with 
regard  to  the  matter  under  consideration;  but  others  are  more 
likely  to  develop  different  points  of  view  within  the  group  itself. 
Mr.  McLean  places  (with  full  recognition  of  the  possible  excep¬ 
tions)  schools,  churches,  labor  unions,  and  benefit  societies  in  the 
first  class.  The  evidence  gathered  from  a  school  principal  and  from 
his  assistants  will  usually  be  in  substantial  agreement;  the  same 
is  true  of  evidence  from  a  minister  and  a  church  visitor.  He  places 
the  man’s  relatives,  those  of  his  wife,  employers,  former  neigh¬ 
bors,  and  tradesmen  in  the  second  class.  There  is  always  danger 
of  not  finding  the  truth,  he  thinks,  unless  at  least  two  sources 
belonging  to  each  of  these  latter  groups  are  consulted.  We  should 
distinguish  groups  all  of  whose  members  are  likely  to  see  eye  to  eye, 
and  in  which  consultation  with  one  source  may  possibly  suffice,  from 
those  in  which  there  is  likely  to  be  diverse  experience  within  the  group. 

(7)  Contradictions  that  are  apparently  irreconcilable  as  between 
the  evidence  of  one  group  and  that  of  another,  or  as  between  indi- 

1  This  principle  is  illustrated  in  the  case  cited  on  p.  172. 

175 


SOCIAL  DIAGNOSIS 


viduals  in  the  same  group,  mean  that  further  inquiry  is  needed  to 
reveal  motives  and  facts  which  will  reconcile  statements  either  by 
change  or  by  elimination.  The  need  of  further  inquiry  is  also 
indicated,  usually,  when  the  evidence  all  points  in  one  direction 
without  contradiction  or  inconsistency,  but  when  also  the  sum  of 
it  reveals  no  single  possible  next  step  in  treatment  that  promises 
to  be  useful.  This  arrival  at  no  thoroughfare  may  be  due  to  other 
causes,  such  as  lack  of  imagination  and  resource  in  those  respon¬ 
sible  for  taking  the  next  step,  but  one  cause  of  failure  when  we  find 
ourselves  at  this  pass  is  a  serious  and  unsuspected  gap  in  the  in¬ 
vestigation  itself.  We  must  recognise  in  contradictory  evidence  and 
in  a  total  of  evidence  that  reveals  no  plan  of  action,  the  need  of  further 
inquiry. 

The  foregoing  seven  principles  of  choice  in  deciding  the  order 
of  our  consultations  with  Outside  Sources  hardly  deserve  to  be 
styled  principles,  perhaps,  but  from  the  evidence  now  at  hand  it 
is  believed  that  they  will  have  practical  value  for  the  case  worker. 

III.  METHOD 

“Just  after  visiting  a  home  you  come  out  tingling  with  the 
letters  you  want  to  write,  the  telephoning  you  want  to  do,  the  visits 
you  wish  to  make  to  other  parts  of  the  city,  but  by  the  time  you 
get  back  to  the  office,  after  making  visits  on  one  or  two  other  cases, 
all  this  has  oozed  out  through  your  fingertips,  somehow.  But  to 
systematize  what  you  got  in  your  first  visit,  to  conserve  the  feeling 
you  had  when  you  left  the  house  and  put  it  right  into  action,  is 
the  only  way  to  get  results.”  This  comes  from  a  case  worker  who 
was  at  the  head  of  a  busy  district  office  in  which  there  were  often 
nine  or  ten  assistants.  It  suggests  the  loss  of  power  and  of  effi¬ 
ciency  which  follows  a  division  of  work  at  this  point,  especially 
when  the  division  is  carelessly  adjusted.  A  new  assistant  in  a  large 
relief  office  was  not  a  little  disconcerted  when  he  was  given  a  memo¬ 
randum  of  eight  “references”  whom  he  was  to  see  about  a  certain 
client  and  his  family,  without  any  information  as  to  the  problem 
or  so  much  as  a  glimpse  of  the  case  record.  A  division  of  labor  is 
possible,  even  in  so  delicate  a  process  as  arriving  at  a  social  diag¬ 
nosis,  but  it  seldom  comes  without  dislocation  at  this  early  stage. 
After  the  most  important  clues  have  been  followed  up  by  the  one 

176 


OUTSIDE  SOURCES  IN  GENERAL 


who  has  seen  the  client  and  his  family,  it  is  often  possible  to  utilize 
assistance  for  visits  to  minor  sources,  though  even  here  a  full  knowl¬ 
edge  of  all  the  preceding  steps  is  essential  before  attempting  to 
pay  these  additional  visits. 

A  good  deal  will  be  said  in  a  later  chapter  about  communications 
by  letter  and  by  telephone.1  Let  it  suffice  here  to  say  that  evidence 
given  face  to  face  and  eye  to  eye  is  evidence  weighed  and  sifted  by 
a  subtle  process  that  can  never  be  applied  to  letters,  blank  forms, 
or  telephone  messages.  The  witness  of  application  blanks  is  notori¬ 
ously  untrustworthy.  An  examination  of  the  records  of  an  orphan 
asylum  which  formerly  based  all  its  admission  decisions  upon  the 
answers  filled  out  upon  such  blanks  reveals  astonishing  misstate¬ 
ments  from  presumably  responsible  public  officials  and  from  trades¬ 
men,  teachers,  and  relatives.  There  would  seem  to  be  something 
very  demoralizing  about  a  blank  form.2  Letters  addressed  “to 
whom  it  may  concern”  are  almost  as  bad;  so  are  letters  of  recom¬ 
mendation  of  all  kinds.  People  sometimes  say  quite  unblushingly, 
when  asked  by  a  social  agency  why  they  wrote  this  glowing  letter 
about  a  certain  weakling,  “  Well,  I  hoped  you’d  do  something  for 
him.”  When  seen  personally,  they  soon  realize  that  the  situation 
is  not  nearly  so  simple  as  all  this,  and  are  led  on,  by  one  who  quickly 
grasps  their  point  of  view,  to  think  more  deeply  and  testify  more 
truthfully.  The  personal  interview,  whenever  it  can  be  obtained 
without  irritating  an  overbusy  person,  is  the  best  method  of 
approach. 

All  of  our  clues  can  be  quite  perfunctorily  followed  up,  however, 
even  when  each  source  is  personally,  carefully,  and  exhaustively 
seen.  The  unimaginative  worker,  the  “overworked  victim  of 
routine,”  can  go  through  all  the  motions  without  achieving  any¬ 
thing  but  irritation  and  disorganization.  We  must  have  a  generous 
conception  of  what  can  and  should  be  done,  and  some  time  in 
which  to  do  it,  before  these  outside  informants  can  be  made  to  con¬ 
tribute  either  useful  information  or  friendly  service.  The  worker 
with  no  such  generous  conceptions  and  purposes  takes  just  as  long 
to  go  and  just  as  long  to  come  back,  his  carfares  and  shoe  leather 

1  Chapter  XVII,  Letters,  Telephone  Messages,  etc. 

2  An  exception  to  this  is  in  the  filling  out  of  those  public  documents  for  misstate¬ 
ments  in  which  a  penalty  is  attached  by  law. 

'2  ,77 


SOCIAL  DIAGNOSIS 


are  just  as  expensive,  and  he  is  pretty  sure  to  discover  that  nobody 
can  do  anything,  that  all  the  persons  consulted  know  very  little, 
and  are  chary  of  imparting  that  little  to  him.  “  In  these  records/' 
wrote  a  director  of  one  charity  organization  society  who  had  been 
asked  to  criticize  some  of  the  case  histories  of  another,  “when  the 
investigation  is  really  begun,  there  seems  to  be  a  greater  endeavor 
to  get  at  facts  than  to  get  advice  as  to  what  to  do;  they  give  the 
impression  of  clerical  interviews  for  information  rather  than  a  con¬ 
sidering  together  and  a  securing  of  co-operation  from  all  the  per¬ 
sons  interested/'  This  result  is  not  always  due  to  perfunctoriness 
and  lack  of  enthusiasm.  It  sometimes  comes  from  an  enthusiastic 
interest  in  our  own  plans  and  purposes.  We  are  so  full  of  them 
that  we  never  give  the  other  person  a  chance  to  help  in  forming 
them. 

“One  of  the  axioms  of  social  diagnosis  is  that  if  a  source  is  worth 
consulting  at  all,  it  is  worth  consulting  in  the  right  way."  Many 
of  the  things  that  have  been  said  about  the  method  of  a  first  inter¬ 
view  apply  to  interviews  with  the  family  group  and  to  these  visits 
paid  to  Outside  Sources  also.  We  must  give  the  one  interviewed 
ample  time  in  which  to  develop  his  point  of  view;  must  not  sug¬ 
gest  the  answers  to  our  questions;  must  utilize  to  the  full  all  new 
avenues  of  approach  and  all  natural  openings,  instead  of  shaping 
the  interview  to  meet  some  preconceived  idea  of  its  content;  and 
yet  must  keep  the  goal  of  a  fuller  knowledge  and  wider  co-operation 
always  in  view. 

We  progress,  in  these  inquiries,  toward  the  point  at  which  we 
can  feel  justified  in  assembling  all  our  data  and  making  a  social 
diagnosis.  Examination  of  our  material  as  a  whole  is,  in  fact,  the 
most  neglected  of  all  the  diagnostic  processes,  but  its  consideration 
here  will  have  to  be  postponed  until  the  various  groups  of  Outside 
Sources  have  been  reviewed.  Meanwhile,  we  must  not  forget  that 
the  reasoning  processes  come  into  play  as  soon  as  the  first  interview 
with  a  client  opens1  and  are  heeded  also  in  every  consultation  with 
an  Outside  Source.  At  the  time  of  each  such  consultation  and  be¬ 
tween  the  different  ones,  we  must  be  comparing,  reconciling,  con¬ 
trasting  every  statement  with  every  other,  and  seeking  to  fill  those 
gaps  in  the  evidence  which  have  a  direct  bearing  upon  the  main 

1  See  p.  120  and  Chapter  V,  Inferences. 

178 


OUTSIDE  SOURCES  IN  GENERAL 

1 

issue  and  its  solution.  A  conception  of  the  different  kinds  of  evi¬ 
dence  described  in  Chapter  III,  and  of  the  characteristics,  detailed 
in  Chapter  IV,  of  human  beings  as  witnesses,  should  enter  into 
and  shape  all  these  contacts  with  Outside  Sources. 

SUMMARY  OF  THIS  CHAPTER 

1.  A  client’s  social  relations  are  not  bounded  by  his  immediate  family,  nor,  as  a 
rule,  should  our  sources  of  insight  and  co-operation  *be  so  bounded. 

2.  A  study  of  the  Outside  Sources — sources  outside  the  immediate  family  group, 
that  is — consulted  in  three  cities  by  56  social  agencies  of  19  different  types  (render¬ 
ing  14  different  forms  of  service  in  the  cases  studied)  shows  in  2,800  cases  (50  for 
each  agency)  10,871  consultations  with  such  sources,  counting,  in  any  one  case, 
only  the  first  consultation  with  each  source  used. 

3.  The  groups  of  Outside  Sources  frequently  used,  as  shown  in  this  study,  are 
social  agencies  and  churches,  doctors  and  health  agencies,  former  and  present  neigh¬ 
borhoods,  relatives,  former  and  present  employers,  schools,  friends,  and  public 
records. 

4.  The  following  seven  principles  may  govern  choice  in  deciding  the  order  in 
which  Outside  Sources  should  be  consulted,  though  such  accidental  things  as  dis¬ 
tance,  accessibility,  and  need  of  unusually  prompt  action,  will  undoubtedly  modify 
their  use. 

(1)  Strike  out  boldly  for  history. 

(2)  Seek  first  those  sources  that  are  likely  to  be  rich  in  history  only,  and  seek 
later  those  most  likely  to  be  rich  also  in  co-operation. 

(3)  Seek  out  the  witnesses  who  have  been  able  to  make  first-hand  observations 
in  preference  to  those  whose  information  is  at  second-hand. 

(4)  Recognize  the  special  value  of  supplementary  clues — of  clues,  that  is,  to 
sources  of  information  not  revealed  in  the  first  interview  or  in  subsequent 
ones  with  the  family  group,  but  which  come  to  light  in  the  course  of  inquiry.. 

(5)  Think  of  sources  in  groups,  and  tap  each  group  for  a  new  set  of  experiences. 

(6)  Distinguish  groups  all  of  whose  members  are  likely  to  see  eye  to  eye,  and  in 
which  consultation  with  one  source  may  possibly  suffice,  from  those  in  which 
there  is  likely  to  be  diverse  experience  within  the  group. 

(7)  Recognize  in  contradictory  evidence,  and  in  a  total  of  evidence  that  reveals 
no  plan  of  action,  the  need  of  further  inquiry. 

5.  Consultations  with  Outside  Sources  are  best  held  by  the  one  who  has  conducted 
the  first  interview  with  a  client  and  seen  his  family. 

6.  Evidence  given  face  to  face  and  eye  to  eye  is  weighed  and  sifted  by  a  subtle 
process  that  can  never  be  applied  to  letters,  blank  forms,  or  telephone  messages. 


179 


CHAPTER  IX 


RELATIVES  AS  SOURCES 


BETWEEN  the  different  forms  of  social  case  work,  it  will 


be  seen  that,  in  the  first  city  (where  such  comparisons  could 


1  L  be  most  safely  made),  the  suburban  and  the  city  charity 
organization  society  consulted  with  35  and  36  Relatives  respectively 
in  their  50  cases  each,  the  general  private  relief  society  with  39, 
the  public  outdoor  relief  department  with  42,  the  society  to  pro¬ 
tect  children  from  cruelty  with  51,  the  city  and  state  departments 
for  care  of  children  with  68  and  44  respectively,  three  child-placing 
agencies  with  89,  44,  and  48  respectively,  a  reform  school  with  26, 
a  children’s  institution  with  20,  a  day  nursery  with  29,  and  three 
hospital  social  service  departments  with  11,6,  and  23  respectively.1 
Relatives  were  seldom  consulted  by  the  juvenile  court,  but  in  most 
forms  of  children’s  work,  in  family  work,  and  in  medical-social 
work  (though  here  in  a  less  degree)  the  figures  show  frequent  con¬ 
sultations.2 

What  does  the  reading  of  case  records  and  the  evidence  of  case 
workers,  in  so  far  as  it  has  been  possible  to  collect  this  in  many 
interviews  with  them,  show  as  to  Relatives?  Clients  often  do  not 
want  their  Relatives  seen.  Why  is  this,  and  what  mistakes  of  the 
social  worker  may  justify,  at  least  in  part,  this  position?  More 
and  more  social  workers  are  seeking  out  Relatives,  though  more 
and  more  they  are  discovering  their  bias,  and  the  need  of  sifting 
their  evidence  with  great  care.  Just  what  is  gained  in  accuracy 

1  Appendix  II,  Table  B. 

2  It  must  be  remembered  that  only  the  Relatives  outside  the  immediate  family 
group  were  counted  in  the  outside  sources  study.  The  use  of  the  word  Relatives 
in  this  chapter  is  subject  to  the  same  limitation  but  to  no  other,  for  it  here  indicates 
relationship  by  birth,  by  marriage,  or  by  descent.  Brothers  and  sisters  living  at 
home  are  counted  as  members  of  the  family  under  treatment;  if  living  away  from 
the  family,  they  are  classified  as  Relatives.  A  client’s  kindred  and  his  wife’s 
kindred  are  regarded  here  as  his  and  her  Relatives,  though  the  distinction  between 
connection  by  marriage  and  connection  by  descent  or  birth  is  an  important  one  to 
make  in  our  consultations. 


180 


RELATIVES  AS  SOURCES 


of  diagnosis  and  effectiveness  of  treatment  through  this  source 
which  can  be  had  in  no  other  way?  From  the  data  at  hand,  what 
is  the  case  for  and  the  case  against  Relatives  as  helps  in  social  ser¬ 
vice,  and  more  especially  in  its  initial  stages? 

I.  THE  CASE  AGAINST  RELATIVES 

To  state  this  side  of  the  case  briefly:  (i)  they  are  partisan  and 
prejudiced;  (2)  they  do  not  know;  (3)  they  do  not  understand. 
It  may  be  added  that  they  are  often  too  overburdened  to  aid  their 
kindred  financially  without  doing  themselves  and  their  immediate 
families  injustice.  This  last  argument  applies  only  indirectly  to 
diagnosis,  but,  since  it  does  apply,  it  will  be  considered  in  a  later 
section  of  this  chapter. 

1.  Relatives  Are  Partisan  and  Prejudiced.  This  is  undoubtedly 
true,  as  the  following  instances  show,  but  a  great  deal  of  truth  may 
be  had  from  a  prejudiced  witness,  if  we  are  careful  to  give  his 
prejudice  due  weight  and  compare  his  statements  with  those  of 
others  who  have  not  the  same  bias. 

A  widow,  Mrs.  D,1  was  a  Catholic;  her  husband  had  been  a  Protestant.  Before 
a  regular  allowance  was  organized  for  her  and  her  five  children,  the  oldest  of  whom 
was  twelve,  three  of  her  Relatives  and  two  of  her  deceased  husband’s  were  seen. 
According  to  his  Relatives  she  was  a  spendthrift,  was  getting  help  from  both  Protes¬ 
tant  and  Catholic  churches,  had  very  quickly  run  through  $300  raised  for  her  by  a 
local  politician,  had  no  ambition,  had  shown  herself  entirely  ungrateful  for  the  help 
already  given  by  her  husband’s  people,  etc.  Her  own  Relatives  represented  her  as 
an  excellent  mother  and  homemaker,  as,  in  short,  a  model  person.  The  truth  was 
found  to  be  somewhere  between  these  two  extremes.  The  stories  of  the  $300  and 
of  the  help  from  Protestant  churches  proved  to  be  untrue,  but  some  of  the  com¬ 
plaints  of  the  husband’s  people  were  well  founded,  and  the  plan  of  regular  assistance 
under  personal  supervision  which  was  adopted  worked  all  the  more  successfully 
because  these  contradictory  statements  had  been  sifted  and  to  a  certain  extent  rec¬ 
onciled  before  the  plan  was  entered  upon. 

A  widower  with  three  children  (man  somewhat  intemperate)  had  been  referred 
to  a  children’s  aid  society  to  make  plans  for  the  children’s  care,  with  the  suggestion 
that  the  man’s  sister  Jane  might  possibly  become  a  homemaker  for  the  family. 
The  mother  of  the  dead  wife,  anxious  to  keep  the  children  from  the  father’s  Rela¬ 
tives,  states  that  Jane  is  under  fourteen,  small  for  her  age,  and  unfit  to  care  for  a 
home.  The  widower’s  mother,  interested  in  securing  the  opportunity  for  her 
daughter,  states  that  Jane  is  over  sixteen,  strong,  large,  and  capable.  A  paternal 


1  See  p.  172  for  other  facts  concerning  this  same  family. 

l8l 


SOCIAL  DIAGNOSIS 


aunt,  not  so  biased  as  the  immediate  family,  states  that  Jane  is  fifteen,  a  very  wild 
girl  and  one  who  could  not  be  managed  even  at  home. 

These  violent  prejudices  as  between  the  Relatives  on  one  side 
of&the  house  and  those  on  the  other  often  take  the  form  of  mischief¬ 
making  between  husband  and  wife.1  One  record  studied  shows 

1  “It  is  surprising  to  find  in  how  many  cases  of  trouble  between  husband  and 
wife  discord  is  aggravated,  if  not  caused,  by  the  often  well  intentioned  interference 
of  friends  or  relatives.  To  an  outsider,  even  though  he  be  a  near  relative,  domestic 
conditions  are  apt  to  appear  much  less  endurable  than  they  actually  are  tlfcthe  par¬ 
ties  most  concerned,  and  he  usually  m ak'es'a  ’foTer a b  1  e  situ ariui  I ’iTTttfferab  1  e  oy  trying 
to  act  as  a  deus  ex  macbina. 

“As  to  the  application  of  the  above:  A  girl  was  born  in  New  York  City  of  parents 
born  in  Germany.  They  brought  German  traditions  with  them,  and  trained  their 
children  to  implicit  obedience.  The  wife  had  been  chastised  by  her  mother  even 
after  marriage,  and  conceived  of  disobedience  to  parental  authority  as  a  degenerate 
thing.  The  American-born  daughter,  despite  this  rigid  discipline,  took  a  slightly 
modified  view  of  her  filial  obligations.  She  had  a  social  nature  and  frequently 
joined  her  young  acquaintances  of  an  evening.  With  the  pardonable  anxiety  of  a 
girl’s  guardians,  her  parents  would  question  her  very  closely  on  her  return,  and, 
for  that  matter,  scolded  her  roundly  for  gadding  so  much.  A  young  Irishman 
presently  figured  on  her  horizon,  an  amiable,  affectionate  young  fellow,  who  made 
much  of  her  and  grew  indignant  at  the  beratings  she  complained  of  receiving  at 
home.  The  contrast  between  his  gentleness  and  parental  strictness  overcame  her 
compunctions,  and  one  day  they  went  to  the  church,  she  became  a  Catholic,  and 
they  were  duly  married.  Her  family  were,  as  she  expressed  it,  ‘wild/  but  the  deed 
was  done. 

“In  the  course  of  time,  first  one  child  then  another  was  born  to  them.  The 
young  husband  did  fairly  well.  .  .  .  The  girl’s  parents,  however,  were  never 

reconciled  to  him.  They  couldn’t  overlook  the  difference  of  race,  and  their  daugh¬ 
ter’s  change  of  religion  was  a  constant  cross.  Although  she  had  taken  two  re¬ 
bellious  steps  she  was  by  no  means  free  from  their  yoke,  and  not  only  did  her  duty 
by  going  to  see  her  mother  frequently,  but  also  felt  constrained  to  make  her  mother 
the  confidante  of  her  husband’s  failings — he  drank  occasionally.  Their  first  preju¬ 
dice  fanned  to  fury  by  their  daughter’s  complaints,  the  parents  insisted  on  her 
bringing  the  delinquent  into  court.  He  was  sentenced  to  six  months’  imprison¬ 
ment.  The  wife,  a  mere  slip  of  a  woman,  tried  with  what  little  aid  her  family  could 
give  her  to  defray  her  expenses  by  taking  a  janitress's  place  in  a  damp  basement. 
The  work  was  too  much  for  her,  and  worry  over  her  husband  kept  her  unsettled. 
She  got  run  down,  and  the  baby  began  to  pine.  Too  ignorant  to  perceive  that 
there  was  occasion  for  anxiety,  she  called  no  doctor  and  was  terrified  and  bewildered 
to  wake  up  one  morning  and  find  the  little  thing  had  died  without  a  sound. 

“That  decided  her.  Her  husband  had  been  writing  her,  begging  her  to  take 
him  out  and  promising  never  to  drink  again,  yet  she  had  hesitated.  The  parents 
threatened  that  if  she  took  him  back  they  would  never  lift  a  finger  to  help  her  no 
matter  to  what  extreme  of  poverty  pr  suffering  she  might  come.  She  must  choose 
once  and  for  all  between  them  and  him.  She  chose  .  .  .  begged  the  magis¬ 

trate  to  let  her  husband  return  to  her,  and  said  that  she  would  move  a  long  dis¬ 
tance  away  from  her  parents,  because  she  was  too  weak,  too  much  under  their 
influence  to  live  happily  with  her  husband  if  she  tried  to  hold  to  them  at  the  same 
time.  Her  request  was  granted,  and  the  young  couple  settled  in  another  city. 
He  understood  his  wife’s  pliable  nature  well  enough  to  forgive  her  entirely  for  hav¬ 
ing  overpunished  him.” — Ada  Eliot  (now  Mrs.  Sheffield)  in  Charities  for  March  29, 
1902.  [Revised  by  the  author.] 

182 


> 


f 

RELATIVES  AS  SOURCES 

endless  trouble  made  by  the  wife’s  sister  in  a  family  where  the 
husband  was  already  inclined  to  be  jealous. 

2.  Relatives  Do  Not  Know.  Sometimes  the  most  important  fact 
in  the  life  of  our  client,  the  one  most  vitally  affecting  his  welfare, 
is  not  known  to  the  Relatives  at  all.  As  has  been  said  in  an  earlier 
chapter,  kinship  makes  not  only  for  sympathy  but  for  antagonism. 
The  mere  closeness  of  the  bond  often  leads  to  concealment. 

3.  Relatives  Do  Not  Understand.  Even  where  there  has  been 
no  cor^ealment,  they  do  not  understand  the  situation  as  well  as 
they  think  they  do;  they  cannot  choose  wisely  between  the  effec¬ 
tive  and  the  ineffective  plan  of  action;  they  have  not  themselves 
a  sense  of  social  values. 

“  I  remember,”  writes  a  former  district  secretary  of  a  charity  organization  society, 
“laboring  with  a  dear  old  man,  an  elder  in  a  Baptist  church,  to  convince  him  that 
some  radical  change  was  needed  in  the  manner  of  life  of  his  brother’s  family,  which 
consisted  of  a  drunken  father,  a  bedridden  wife,  and  three  daughters,  on  two  of 
whom  the  burden  of  support  fell.  Their  wages  were  insufficient  for  the  family  of 
five.  All  that  I  could  get  from  him  was  that  the  past  must  be  buried  and  that  Jim 
must  be  helped  now  even  if  he  had  done  wrong  in  the  past.  It  was  odd  that  the 
girls  had  not  mentioned  their  distress,  but  he  would  go  down  there  at  once.  That 
the  girls  should  have  better  jobs,  that  the  woman  should  have  hospital  care,  and 
that  the  man  should  be  supplied  with  light  work  and  watched  faithfully,  were  ideas 
beyond  his  range.” 

A  society  to  protect  children  from  cruelty  in  a  large  city  finds 
Relatives  so  likely  to  interfere  disastrously  in  court  cases  of  neglect 
that,  as  a  rule,  where  the  conditions  are  obviously  bad,  it  does  not 
see  the  Relatives  at  all  until  after  court  action.  The  society  finds 
that  this  involves  less  danger  of  making  trouble  in  the  family,  and 
makes  it  easier  to  turn  to  the  kindred  on  both  sides,  who  are  seen 
later  of  course,  either  for  the  care  of  one  or  more  of  the  children 
or  for  active  assistance  in  helping  the  family  to  establish  a  home 
standard  that  will  warrant  the  return  of  the  children. 

One  of  its  cases  was  that  of  a  father  up  for  neglecting  to  support  his  children. 
The  man  was  sentenced  to  the  workhouse  for  a  year,  but  appealed  the  case.  The 
decision  was  reversed  in  the  superior  court  on  the  evidence  of  a  brother-in-law  and 
a  sister,  both  of  whom  had  been  strongly  urging  the  S.  P.  C.  C.  to  do  something 
about  the  wretched  conditions  of  which  they  made  complaint.  In  court  they 
testified  that  the  father  had  been  doing  his  very  best.  Before  taking  the  case  into 
court  at  all  the  society  had  consulted  a  landlady,  a  previous  landlord,  a  policeman, 
and  three  Relatives,  and  had  itself  inspected  the  home  conditions  on  several  oc- 

.83 


SOCIAL  DIAGNOSIS 


casions.  In  the  presence  of  their  common  enemy,  the  court.  Relatives  often  give 
directly  opposite  testimony  from  that  which  is  secured  in  private  interviews. 

A  country  society  to  protect  children  reports  that  kindred  in 
its  rural  neighborhood  can  be  seen  far  more  safely  before  a  court 
trial  than  in  the  city,  and  that  their  co-operation,  both  in  court 
and  out,  can  be  better  counted  upon.  The  work  of  the  society 
seems  to  be  better  understood  and  to  be  taken  more  seriously. 
One  reason  for  this,  probably,  is  that  public  opinion,  for  better  or 
worse,  is  more  completely  unified  in  the  small  place  and  more  in¬ 
fluential  there  for  that  reason.  In  the  large  city  there  are  many 
and  conflicting  community  standards,  and  the  standard  that  has 
found  expression  in  a  law  or  a  social  agency  may  not  be  the  one 
that  is  most  compelling  within  a  certain  neighborhood  group. 

A  public  department  for  dependent  children  found  it  impossible  to  secure  court 
action  in  the  case  of  a  feeble-minded  woman  who  had  given  birth  to  her  third  il¬ 
legitimate  child  and  obviously  needed  custodial  care.  This  was  owing  to  the  ap¬ 
pearance  of  the  Relatives  with  an  offer  to  care  for  her  and  her  children.  The  chil¬ 
dren  were  later  found  to  be  neglected,  but  the  mother  was  then  in  Canada  beyond 
the  jurisdiction  of  the  court.  A  critic  of  this  example  writes,  “Could  not  the  public 
department  have  persuaded  the  court  to  put  these  relatives  under  bond  to  keep  the 
woman  and  children  off  the  public?  If,  among  them,  they  were  able  to  care  for  a 
whole  family — minus  the  man — they  should  have  been  able  to  give  some  sort  of 
security." 

A  probation  officer  whose  work  shows  more  than  the  usual  degree 
of  skill  states  that  she  deems  it  inadvisable  to  see  Relatives  except 
in  those  cases  in  which  it  seems  impossible  to  get  at  the  situation 
without  consulting  them,  or  those  that  involve  the  taking  of  a 
boy  or  girl  out  of  the  family.  Ordinarily  she  believes  that  seeing 
the  Relatives  “stirs  up  a  lot  of  talk  and.ieads  nowhere/'  In  many 
of  the  families  known  to  her  the  family  connections  feel  no  shame 
whatever  about  a  boy’s  being  brought  to  court,  nor  does  the  boy 
himself  feel  any.  There  is  little  reticence  about  such  matters,  and 
she  feels  that  the  only  way  to  help  the  family  to  a  proper  sense  of 
shame  is  to  say  to  them,  “You  surely  do  not  intend  to  talk  this 
thing  over  with  your  sisters’  and  brothers’  families.  If  I  were 
you  I  should  be  so  ashamed  of  it  that  I  should  never  let  anyone 
know  that  it  had  happened.” 

From  this  same  probation  officer,  however,  comes  a  memoran¬ 
dum  of  a  boy  on  probation  whose  mother  had  two  married  sisters 

184 


RELATIVES  AS  SOURCES 


and  a  brother  just  learning  his  trade.  Through  an  interview  with 
one  of  these  sisters  the  officer  gained  sufficient  confidence  in  the 
family’s  sense  of  solidarity  to  arrange  a  conference  of  all  the  Rela¬ 
tives,  at  which  she  succeeded  in  persuading  them  to  place  the  boy 
in  a  Catholic  college  and  pay  his  board  there.1  By  way  of  recon¬ 
ciling  these  two  entirely  different  modes  of  procedure  she  would 
only  need  to  point  out  that  she  was  dealing  with  two  entirely  dif¬ 
ferent  groups  of  people.  In  her  first  statement  she  was  probably 
referring  to  a  group  that  were  as  little  attuned  to  legal  processes 
as  the  Aran  Islanders  described  by  John  Synge.  The  law  courts, 
which  had  been  superimposed  upon  this  primitive  people  and  were 
presided  over  by  outsiders,  were  often  used  as  playthings  by  the 
Islanders.  A  whole  family  connection  would  come  down  to  the 
court  and  swear  against  all  the  representatives  of  another  family 
connection  until  they  became  bitter  enemies.  ‘'The  mere  fact 
that  it  is  impossible  to  get  reliable  evidence  in  the  island — not 
because  the  people  are  dishonest,  but  because  they  think  the  claim 
of  kinship  more  sacred  than  the  claims  of  abstract  truth — turns 
the  whole  system  of  sworn  evidence  into  a  demoralizing  farce.”2 

Without  giving  too  much  weight  to  any  of  the  foregoing  argu¬ 
ments,  it  may  be  acknowledged  that  social  workers  often  show  a 
lack  of  discrimination  as  to  which  Relatives  to  see  and  when.  A 
qualitative  standard  is  more  important  than  a  quantitative  one 
not  only  in  the  study  of  sources  in  general,  but  in  their  daily  use. 
If,  as  a  story  develops,  the  most  important  factor  in  the  situation 
seems  to  be  lack  of  employment,  it  is  foolish  to  see  five  Relatives 
on  one  side  of  the  house  and  four  on  the  other,  and  then  omit  for 
lack  of  time  all  of  the  three  previous  employers.  A  number  of  the 
case  records  examined  showed  a  rather  heedless  running  about 
from  one  Relative  to  another,  apparently  for  the  sole  purpose  of 
checking  their  names  off  as  “visited”  upon  the  face  card  of  the 
record. 

Another  mark  of  careless  work  is  the  tendency  to  turn  children 
over  to  the  care  of  Relatives  simply  because  they  are  Relatives, 
when  the  truth  of  their  statements,  their  character,  habits,  and 


1  For  another  instance  of  co-operation  with  Relatives  in  probation  work,  see 
p.  193. 

2  Synge,  John:  The  Aran  Islands,  p.  98.  Boston,  Jno.  W.  Luce  Co.,  1911. 

185 


SOCIAL  DIAGNOSIS 


circumstances  have  not  been  inquired  into  at  all.  The  practice 
is  a  common  one,  and  will  continue  to  be  so,  probably,  so  long  as 
public  departments  and  private  agencies  do  not  require  and  pro¬ 
vide  for  individualized  inquiry  and  treatment,  or  so  long  as  their 
appointed  agents  are  mentally  and  morally  sluggish  and  inclined 
to  do  the  thing  that  is  easiest. 

An  S.  P.  C.  C.  had  occasion  to  take  up  a  complaint  involving  two  small  children, 
a  boy  and  a  girl,  who  were  living  with  their  grandfather.  It  was  found  that  an 
overseer  of  the  poor,  who  had  been  aiding  the  family  of  these  children  before  the 
death  of  the  mother,  had  allowed  them  to  be  taken  by  the  Relatives  without  any 
investigation  whatever.  The  boy,  who  was  lame,  was  not  receiving  proper  care, 
the  girl  was  out  of  school,  and  the  whole  family  were  living  in  an  old  shack  of  one 
room. 

An  argument  that  can  hardly  be  included  in  this  case  against 
Relatives,  yet  that  nevertheless  has  some  bearing,  was  well  put  to 
the  writer  by  a  man  applying  for  transportation  to  Chicago.  It 
transpired  that  he  had  a  brother-in-law  in  the  railroad  business, 
and  when  correspondence  with  this  Relative  was  suggested,  the 
man  said  frankly,  “No,  madam,  I'd  rather  not  have  him  communi¬ 
cated  with.  Td  much  rather  have  help  from  you,  because  I  shall 
never  see  you  again."  From  the  client's  point  of  view  one  objec¬ 
tion  to  Relatives,  as  sources  of  help  at  least,  is  the  sense  of  mutual 
obligation  that  is  involved  in  a  permanent  relationship.  The 
feeling  is  seldom  expressed  so  frankly,  but  it  is  often  there. 

II.  THE  CASE  FOR  RELATIVES 

Experience  throws  into  bold  relief  the  prejudice  and  the  un¬ 
wisdom  of  Relatives,  but  there  is  plenty  of  evidence  on  the  other 
side  which  shows  that  in  actual  daily  practice  social  workers  are 
not  only  securing  (i)  individual  and  family  history  from  kinsfolk, 
but  are  finding  them  a  fountainhead  of  (2)  insight  (a  more  im¬ 
portant  matter  than  history),  and  also  an  effective  source  of  (3) 
backing  and  active  co-operation. 

1.  Individual  and  Family  History.  “Too  often,"  writes  a  case 
worker,  “we  consider  simply  the  individual  family  and  say,  ‘This 
man  drinks,'  ‘This  woman  is  not  a  good  housekeeper,’  when  as  a 
matter  of  fact  a  study  of  the  family  background  would  give  us  an 
insight  into  causes.  This  background  comes  best  from  the  rela¬ 
tives."  Far-reaching  inquiry  such  as  eugenic  studies  call  for  is  of 

186 


RELATIVES  AS  SOURCES 


course  out  of  the  question,  but  the  gathering  of  certain  facts  con¬ 
cerning  the  nearer  Relatives  is  an  important  part  of  social  diagnosis 
because  it  has  a  direct  bearing  upon  treatment. 

In  cases,  for  instance,  where  the  social  worker  has  reason  to 
suspect  the  presence  of  mental  disease,  he  must  aim  to  get  at 
facts  of  heredity  which  would  assist  a  physician  in  forming  an 
opinion  of  the  patient’s  condition.  The  pertinent  data  would 
cover  the  condition  of  health  and  cause  of  death  of  parents,  grand¬ 
parents,  brothers  and  sisters,  uncles  and  aunts.  The  items  should 
be  especially  clear  and  detailed  whenever,  in  any  of  these  Rela¬ 
tives,  there  seems  to  be  a  question  of  consanguineous  marriage,  of 
miscarriages,  of  tuberculosis,  alcoholism,  mental  disorder,  nervous¬ 
ness,  epilepsy,  cancer,  deformities  or  abnormalities,  or  of  any  ex¬ 
ceptional  ability.  Relatives  often  have  knowledge  of  these  things 
which  members  of  the  immediate  family  have  not,  and  often  they 
are  less  reticent.  The  case  worker,  for  his  part,  must  be  familiar 
enough  with  the  symptoms  of  the  diseases  mentioned  to  note  at 
once  any  casual  reference  to  them  and  then  follow  up  the  reference, 
making  a  point  of  getting  all  the  facts  he  can  about  the  health  of 
the  person  in  question. 

The  warning  will  be  given  elsewhere,  but  it  should  be  stated 
here  too  that  in  recording  this  evidence  of  Relatives  the  social 
worker  should  mention  symptoms  only,  excluding  diagnosis  ex¬ 
cept  as  it  comes  from  competent  medical  authority.  Even  in  so 
clear  a  case  as  pronounced  imbecility,  he  should  record,  for  ex¬ 
ample,  “John’s  uncle  says  that  John’s  sister  Mary  was  ‘not  right,’ 
that  she  could  never  learn  to  hew  and  cook,”  etc.,  including  all  the 
evidence  but  drawing  no  conclusion. 

Relatives,  then,  are  our  main  reliance  for  family  history,  for 
the  story  of  those  traits  and  tendencies,  those  resemblances  and 
differences  in  a  family  stock  which  we  are  learning  to  regard  as  of 
far-reaching  importance. 

A  large  orphan  asylum,  which  is  giving  a  very  good  education  to  its  inmates  and 
wishes  to  limit  its  admissions  to  normal  children,  now  not  only  depends  in  making 
its  selections  upon  a  school  examination  and  certain  mental  tests,  but  tries  to  see  as 
many  Relatives  on  both  sides  of  the  family  as  possible.  Especially  in  the  cases 
about  which  there  is  some  doubt,  the  asylum’s  investigator  feels  that  a  personal 
interview  with  each  Relative  is  necessary.  In  making  55  investigations  prelimin¬ 
ary  to  the  admissions  of  one  month,  this  worker  made  79  visits  to  Relatives,  and 

187 


SOCIAL  DIAGNOSIS 


in  studying  25  other  cases  of  children  whose  fitness  for  admission  was  especially  in 
question,  he  saw  Relatives  94  times. 

2.  Insight.  Some  items  of  evidence  have  social  significance 
because  they  suggest  new  sources  of  information  or  possible  helps 
in  treatment  later  on,  while  others  are  valuable  because  they  help 
us,  at  a  time  when  we  have  felt  balked  and  unable  to  decide  how 
to  proceed,  to  grasp  at  once  the  core  of  the  difficulty.  Relatives 
are  not  the  only  sources  that  can  give  these  sudden  insights,  but 
they  so  often  point  the  way  in  what  have  been  no-thoroughfare 
situations,  that  case  workers  have  become  almost  superstitious 
about  the  one  Relative  who  has  not  been  seen. 

Even  when  the  Relatives  are  unco-operative  their  stories  are  revealing.  “1 
remember  one  instance,”  writes  a  worker,  “where  the  mother  flatly  refused  to  aid 
the  daughter’s  family  in  any  way,  where  the  brothers  and  sister  were  too  self- 
absorbed  to  share  with  their  sister  even  in  her  great  distress.  Yet  the  stand  these 
people  took,  in  all  its  ugliness,  pictured  the  story  vividly — a  disobedient,  ungrateful 
daughter  and  a  selfish  and  careless  sister,  a  woman  who  would,  in  all  probability, 
make  an  indifferent  wife  and  mother.  This  knowledge  was  of  service  in  planning 
the  method  of  attack  in  that  particular  family.” 

Illustrations  of  securing  from  Relatives  the  one  essential  clue — essential,  that 
is,  to  any  effective  treatment — are  so  plentiful  that  it  is  difficult  to  choose.  Take 
these  two  found  in  desertion  cases.  “We  had  been  dealing  with  a  desertion  case 
quite  a  while,”  writes  a  district  secretary  of  a  charity  organization  society,  “without 
getting  anywhere.  Upon  visiting  the  wife’s  mother  we  got  information  that  the 
husband  was  living  at  his  own  home;  we  went  there  in  the  evening  and  found  him.” 
Another  charity  organization  society  made  an  extensive  canvass  of  Relatives  in  a 
desertion  case,  but  omitted  the  mother  of  the  man.  After  the  society  had  assisted 
the  family  for  fourteen  weeks  and  made  fruitless  attempts,  legal  and  other,  to  find 
the  man,  the  wife  had  a  letter  from  her  mother-in-law  inviting  her  to  visit  her,  and 
two  days  later  a  letter  from  the  man  saying  that  he  was  at  his  mother’s,  where  the 
woman  and  children  joined  him. 

A  case  record  that  came  to  the  attention  of  the  writer  last  year  covers  more 
than  a  hundred  pages  in  reporting  successively  the  work  of  four  different  districts 
of  one  charity  organization  society  with  the  Braucher  family,  the  man  an  American 
in  his  late  thirties  with  a  South  American  wife  and  two  small  children.  His  story 
is  told  at  some  length  here,  because  the  narrative  will  be  referred  to  in  a  later  chap¬ 
ter  on  Comparison  and  Interpretation.  In  transferring  the  treatment  of  this  fam¬ 
ily  from  the  third  district  to  the  fourth,  the  secretary  making  the  transfer  wrote 
that  it  had  been  impossible  to  verify  most  of  the  family’s  statements,  that  Braucher 
had  failed  to  follow  instructions  when  good  medical  care  had  been  procured  for  him, 
and  that  the  family  “showed  industry  as  beggars  but  in  no  other  way.” 

About  fifty  pages  of  the  record  are  filled  with  accounts  of  futile  attempts  to  get 
some  basis  of  fact  on  which  to  operate,  followed  by  attempts  to  befriend  the  family 

188 


RELATIVES  AS  SOURCES 


and  to  improve,  on  the  very  inadequate  data  at  hand,  their  physical  and  economic 
condition.  The  man’s  people  lived  in  another  city,  but  the  local  charities  there  had 
given  nothing  more  definite,  in  reply  to  inquiries,  than  the  statement  that  the  Rela¬ 
tives  had  been  known  to  them  and  that  they  had  “a  discouraging  record.” 

The  secretary  of  the  fourth  district,  taking  advantage  of  a  trip  to  the  neighbor¬ 
hood  of  the  man’s  early  home,  visited  the  charities  formerly  interested  in  his  Rela¬ 
tives,  read  the  “discouraging  record,”  found  that  her  client’s  mother  was  still  living 
(he  had  reported  her  as  dead,  and  seems  to  have  believed  that  she  was),  looked  up 
her  address  with  the  aid  of  directories,  had  a  long  talk  with  her  and  gave  her  the 
first  news  of  her  son  in  many  years.  He  ran  away  from  home  when  he  was  only 
sixteen,  and  his  father,  it  appeared,  had  deserted  the  family  before  that.  This 
personal  visit  to  another  city  gave  the  charity  organization  society  its  first  real  in¬ 
sight  into  the  background  of  its  client.  The  mother  revealed  strong  family  feeling 
and  she  and  her  immediate  family  showed  a  certain  degree  of  resourcefulness. 

The  secretary  returned  with  a  cordial  message  from  her  and  an  offer  to  entertain 
one  of  the  little  grandchildren,  whose  very  existence  had  been  unknown  to  the  Rela¬ 
tives  before.  Armed  with  this  invitation  and  with  news  of  the  man’s  people,  a 
fresh  appeal  was  made  to  him;  his  plans  and  purposes  were  reviewed  in  a  long 
friendly  talk,  and,  from  that  time,  it  was  evident  that  an  interest  which  appealed 
to  him,  a  plan  of  life  which  touched  his  imagination,  had  at  last  been  presented. 
His  first  ambition  was  to  make  a  good  appearance  when  he  visited  his  mother,  as 
he  did  soon  after.  His  wife  also  began  to  share  with  him  the  ambition  to  have  a 
better  home,  to  which  his  mother  could  be  invited  on  a  return  visit.  At  last  there 
seemed  to  Braucher  to  be  a  good  and  sufficient  reason  for  taking  the  few  steps 
necessary  to  make  medical  treatment,  so  ineffective  before,  truly  effective. 

In  less  than  a  year’s  time  after  the  discovery  of  these  Relatives,  the  charity  or¬ 
ganization  society  was  able,  with  the  aid  of  the  family  affection  and  the  new  social 
interest  brought  into  their  lives,  to  transform  these  difficult  clients  into  people  who 
carried  responsibility  more  cheerfully  and  were  more  interested  in  their  little  home. 
The  steps  by  which  this  was  achieved  are  apparent  enough  in  the  matter-of-fact 
pages  of  the  record,  which  show  that  no  magic  was  employed,  and  that  the  measure 
of  success  achieved  was  no  accident,  based,  as  it  was,  upon  the  insights  and  the 
interests  which  a  group  of  Relatives  in  no  sense  remarkable — they  had  once  been 
described  as  “difficult” — had  been  able  to  supply. 

3.  Backing  and  Active  Co-operation.  If  they  are  close  at  hand, 
the  attitude  „of -the..  Relatives  is  seldom  an  entirely  passive  one. 
The  illustration  just  given  shows  that  not  only  insight  but  active 
co-operation  may  be  won  from  Relatives,  and  emphasizes  the  im¬ 
portance  of  communicating  with  them  even  when  they  are  at  a 
distance.  Still  less  can  we  afford  to  ignore  members  of  the  family 
connection  who  live  in  the  same  city  and  who  often  have  very 
definite  ideas  with  regard  to  our  clients.  If  they  are  not  with  us, 
they  may  easily  be  against  us.  It  is  no  unusual  thing  to  find  in 

189 


SOCIAL  DIAGNOSIS 


one  group  of  Relatives  almost  every  variety  of  social  and  anti¬ 
social  attitude,  from  utter  indifference  on  the  one  hand  to  deep 
devotion  and  self-sacrifice  on  the  other.  The  best  of  the  Rela¬ 
tives  are  often  as  thoughtful  and  as  eager  to  help  as  any  social 
worker  ever  was.  Sometimes  we  are  dealing  with  situations  in 
which  the  Relatives  have  failed — those  in  which  they  have  en¬ 
tirely  succeeded  are  not  usually  known  to  the  social  worker — but 
even  in  the  history  of  these  failures  we  may  find  that  the  Relatives 
have  almost  as  strong  a  claim  upon  our  sympathies  as  our  clients 
have,  and  that  they  welcome  our  new,  more  hopeful,  and  more 
resourceful  handling  of  an  old  difficulty.  They  have  had  much 
to  bear  perhaps;  they  have  lost  their  influence  and  are  glad  to 
help  through  another  in  cases  in  which  they  despair  of  helping 
directly  and  effectively. 

The  case  record  of  a  single  woman  of  middle  age  is  commented  upon  by  one  of 
the  case  readers  as  follows:  “This  is  one  of  the  most  real  examples  I  have  ever  seen 
of  bringing  a  woman  up  on  her  feet  and  helping  her  until  she  had  confidence  to  stand 
alone.  Her  great  happiness  in  at  last  being  able  to  do  so  is  pathetic  and  genuine.” 
This  woman  was  the  last  of  her  immediate  family.  Her  father  had  been  a  hard 
drinker,  the  home  had  been  an  unhappy  one,  and  after  its  breaking  up  her  Relatives 
had  wearied  of  helping  one  who  seemed  never  to  rise  to  her  industrial  opportunities. 
The  charity  organization  society  that  attempted  to  befriend  her  interested  a  doctor, 
who  reported  that  she  was  not  mentally  unbalanced,  as  they  had  suspected,  but 
was  undernourished,  sensitive,  and  unpractical.  Work  was  finally  found  for  her 
in  an  office,  but  it  took  a  good  many  months  to  make  her  self-supporting,  and  mean¬ 
while  a  cousin,  who  had  lost  all  patience,  was  made  to  understand  her  real  situation 
and  persuaded  to  aid  regularly  through  the  society. 

The  financial  help  of  a  well-to-do  Relative  is  all  very  well  as 
far  as  it  goes,  but  the  experienced  social  worker  welcomes  as  his 
strongest  ally  in  a  difficult  case  the  Relative  who  shows  tact, 
courage,  and  patience.  The  personal  and  moral  backing  of  the 
Relatives  shown  in  the  following  instances  was  a  great  social  asset. 

Mrs.  Chesley  of  the  Paine  Fund,  Cambridge,  Massachusetts,  writes  of  a  weak 
woman  who  had  never  been  married  to  the  deserting  father  of  her  four  children, 
and  of  the  way  in  which  four  Relatives,  each  showing  a  different  mental  attitude 
toward  the  situation,  worked  for  the  common  good.  “We  wrote  twice  to  the  [pa¬ 
ternal]  grandfather  of  those  children,  trying  to  arrange  an  interview  at  his  con¬ 
venience,  but  received  no  replies.  We  wrote  to  the  [woman’s]  single  brother  twice 
with  the  same  result.  The  married  brother  worked  at  night.  We  wrote  him  that 
we  would  call  on  a  certain  afternoon  at  four  o’clock.  He  then  would  have  had  his 
usual  amount  of  sleep  and  be  ready  to  see  us.  We  found  him  a  kindly,  easy-going 

190 


RELATIVES  AS  SOURCES 


man  with  no  very  decided  opinions.  After  considering  the  facts  he  thought  it 
wise  for  his  sister  to  keep  the  children  together  and  for  his  mother  to  remain  with 
them.  His  own  financial  situation  was  straitened.  He  had  five  children — a  son, 
who  was  a  widowrer  with  one  child,  living  at  home  and  out  of  work;  two  other  sons 
of  working  age,  also  out  of  work;  one  girl  at  work  and  another  in  school.  The 
family  was  held  together  by  his  small  wages  and  what  the  daughter  earned.  He 
was  in  debt  for  rent  and  other  necessities.  He  was  willing  to  give  his  mother  a 
home,  or  would  contribute  toward  her  support,  and  thus  help  his  sister  too.  We 
had  to  show  him  why,  under  the  circumstances,  he  was  not  justified  in  helping  others. 
He  agreed  to  wait  until  the  income  of  the  family  was  larger  and  then  do  what  he 
could. 

“On  visiting  the  married  sister  we  found  that  the  income  of  her  husband  was 
sufficient  only  for  the  support  of  the  immediate  family.  Again  no  financial  aid 
was  promised.  In  the  sister,  however,  we  found  a  strong  moral  character  with  a 
keen  appreciation  of  all  the  difficult  elements  in  the  situation,  and  a  realization  of 
her  duty  to  stand  by  her  weaker  sister  and  the  children.  Because  of  the  lack  of 
family  resources  she  had  urged  that  the  children  be  placed  in  homes.  She  readily 
accepted  the  other  plan,  however,  and  we  left  her,  feeling  that  there  was  at  least 
one  person  on  whom  we  could  depend  for  the  most  sincere  and  cordial  co-operation. 
She  regretted  her  inability  to  help  materially  and  we  hope  she  took  a  little  comfort 
from  our  assurance  that  her  genuine  moral  interest  and  oversight  were  the  indis¬ 
pensable  elements,  the  real  hope,  of  the  situation.  We  found  she  was  a  woman 
very  much  respected  in  a  certain  circle  of  people  among  whom  she  had  lived  all  her 
life.  Her  pride  and  self-respect  were  strong,  and  she  realized  that  at  any  time  her 
sister’s  real  story  might  be  known.  This  did  not  deter  her — her  sister  was  her  sister 
through  good  or  ill  repute,  and  that  ended  the  matter. 

“We  had  now  to  see  those  two  men  who  had  not  replied  to  our  note.  We  called 
on  the  grandfather  of  the  children  one  evening.  He  apologized  at  once  for  not 
writing,  and  when  he  explained  in  detail  the  way  his  time  was  occupied  by  his  work 
and  the  care  of  an  invalid  wife,  we  did  not  wonder  at  the  delay.  With  him  we  had 
to  face  a  most  delicate  and  difficult  situation,  one  that  took  all  our  courage.  Here 
was  a  quiet,  dignified  man  who  had  always  been  fully  competent  to  guide  his  own 
affairs.  He  had  positively  decided  that  his  future  course  as  to  this  family  of  his 
son  was  to  treat  them  as  though  they  were  non-existent.  He  stated  his  reasons  for 
such  a  course — good  reasons,  almost  unanswerable  from  one  point  of  view.  Years 
before  he  had  done  all  he  could  to  prevent  this  union.  He  had  seen  Mrs.  X,  as  we 
still  call  her,  and  told  her  that  his  son  had  a  wife  from  whom  he  had  not  been  di¬ 
vorced.  His  efforts  were  fruitless.  He  had,  too,  given  much  financial  help  during 
the  past  twelve  years,  and  now  he  felt  he  owed  all  he  could  spare  to  the  care  of  his 
sick  wife  and  their  approaching  old  age.  Our  sympathies  were  with  him  and  we 
told  him  so,  although  we  could  not  quite  agree  with  his  conclusions.  We  led  him 
to  consider  the  future  of  the  children  and  his  responsibility  regarding  them.  Finally 
after  due  deliberation,  he  agreed  to  co-operate  for  six  months  by  giving  one  dollar 
a  week,  through  us,  toward  their  support. 

“We  also  called  in  the  evening  on  the  single  son  and  brother.  He  boarded  with 


1 9 1 


SOCIAL  DIAGNOSIS 


a  woman  living  on  the  second  floor  of  a  tenement  house.  The  family  thought  this 
woman  received  most  of  his  wages.  She  was  certainly  in  his  confidence,  for  when 
we  inquired  for  him  through  the  tube  she  would  not  give  any  information  or  open 
the  door  until  the  name  was  given.  Then  the  man  came  rushing  downstairs  ex¬ 
claiming,  as  soon  as  he  opened  the  door,  ‘  I  have  not  answered  your  letters  because 
1  want  nothing  to  do  with  my  sister,  and  anyway  I  have  been  out  of  work,  and  I 
haven’t  any  money  to  give  her.’  We  said,  ‘Good  evening,’  and  then  he  said, 
‘  I  beg  your  pardon,’  and  we  began  our  talk  on  a  more  friendly  basis,  continuing 
the  interview  on  the  steps  outside,  which  seemed  preferable  to  the  possibilities  of 
the  apartment  upstairs.  His  attitude,  plainly  stated,  was  that  he  would  not  help 
support  Mr.  X’s  children.  They  might  be  cared  for  by  the  state  or  in  any  way 
the  community  provided  for  such  children.  We  finally  found  ourselves  discussing 
frankly  his  sister’s  life  and  character,  and  his  own  duties  in  relation  to  her.  He 
saw  that,  in  ways  he  had  not  realized,  he  had  been  a  detrimental  influence.  This 
thought  affected  him  more  than  anything  else.  His  whole  attitude  changed  and 
the  result  was  that  he  promised  one  dollar  a  week  and  some  oversight  over  the 
children,  especially  a  troublesome  nine-year-old  boy.  For  five  months  he  has  kept 
his  promise. 

“Our  next  step  involved  an  extension  of  the  family  idea.  We  asked  a  group  of 
people  who  were  constantly  studying  the  best  interests  of  children,  the  trustees  of  a 
home  for  children,  if  they  would  consider  giving  this  mother  a  cash  allowance  so 
that  with  the  other  resources  she  might  keep  the  family  together.  This  they 
unanimously  voted  to  do  although  it  was  the  first  time  in  the  history  of  the  insti¬ 
tution  that  such  a  course  had  been  taken. 

“Summarizing  the  situation,  we  find: 

“  First,  that  the  grandfather  who  felt  his  duty  ended  saw  a  further  duty;  second, 
that  the  brother  who  acknowledged  no  obligation  to  a  weak  sister  saw  that  he  had 
not  helped  her  to  be  strong;  third,  that  the  married  brother  was  deterred  from  his 
unwise  self-sacrifice;  fourth,  that  the  sister  came  to  realize  that  her  strong  moral 
support  was  of  more  value  than  financial  aid;  fifth,  and  lastly,  that  the  trustees  of 
the  home  took,  as  it  seemed  to  us,  a  progressive  step  away  from  institutionalism.”1 

One  record  submitted  for  study  opens  with  a  picture  of  an  educated  man  who 
had  lost  his  eyesight  through  a  drug  habit,  a  wife  also  addicted  to  drugs,  who  a 
little  later  becomes  insane,  and  their  little  boy,  whom  the  mother  neglects  but  to 
whom  the  father  is  so  devoted  that  he  refuses  to  let  him  be  taken  away.  The 
woman’s  Relatives  in  another  state  did  not  reply  to  letters.  The  man’s  sister  and 
brother,  who  lived  still  farther  away,  wrote  that  they  did  not  wish  to  have  any¬ 
thing  more  to  do  with  him.  A  little  later,  however,  a  third  member  of  his  family, 
another  sister,  who  had  heard  indirectly  of  the  previous  correspondence,  wrote  a 
letter  full  of  intelligent  questions:  “Is  it  true  that  my  brother  has  attempted  to 
take  his  life?  Will  he  not  probably  attempt  to  take  it  again?  Was  drink  or  pov¬ 
erty  the  cause?  Is  he  in  a  rescue  home,  a  hospital,  or  where?  Is  he  a  confirmed 
drunkard,  and  do  you  see  any  conditions  that  would  reform  him?  As  I  under- 

1  Chesley,  Annie  L. :  “  The  Responsibility  of  Family  Life.”  Survey,  May  22,  1909, 
p.  269. 


192 


RELATIVES  AS  SOURCES 


stand,  he  will  not  be  separated  from  the  child.  Is  he  strongly  attached  to  his  wife 
also?”  The  letter  goes  on  to  explain  that  the  writer  had  not  heard  from  her  brother 
for  more  than  ten  years  and  did  not  even  know  that  he  was  married.  She  is  eager 
to  do  all  that  she  can,  but  is  a  widow  in  delicate  health  and  could  not  provide  for 
all  three  of  them.  Then  out  of  the  depth  of  her  interest  more  questions:  “What 
caused  the  blindness?  Is  there  no  hope  that  he  will  ever  see?  It  is  a  cruel  thing  to 
separate  a  family  under  normal  conditions,  but  sometimes  it  has  to  be  for  a  time 
at  least.  How  old  a  woman  might  his  wife  be?  Are  you  a  friend,  a  nurse,  a  mis¬ 
sionary,  or  a  sister  of  charity?  Excuse  the  inquiry.  Do  not  lose  sight  of  him  until 
I  can  hear  from  you.  If  I  should  write  to  him,  would  it  be  wise?  I  have  decided 
to  help  him  if  I  can,  but  that  will  not  be  by  sending  money  there.  ...  I 
cannot  think  he  has  the  thirst  for  drink  that  makes  drunkards.  Some  strong  out¬ 
side  influence,  poverty  or  a  weak  character,  must  be  at  the  bottom.  Tell  the 
particular  cause  of  the  blindness,  and  if  there  is  any  hope  that  it  may  not  be  per¬ 
manent.” 

These  questions  were  answered  as  fully  as  possible.  Meanwhile,  a  further 
effort  had  been  made  to  find  the  woman’s  Relatives.  A  clergyman  in  their  town, 
whose  name  had  been  found  in  a  church  directory,  was  asked  to  visit  them,  since 
no  charitable  organization  could  be  found  to  do  so.  His  intervention  brought  a 
reply  at  last  written  by  the  stepmother  of  the  woman.  It  was  full  of  expressions 
of  sorrow,  and  offered  to  give  a  home  to  the  little  boy,  provided  he  could  be  sent 
at  the  society’s  expense.  The  next  day  brought  a  second  letter  withdrawing  this 
offer,  and  adding  that  if  the  little  boy  is  as  unruly  as  his  mother  used  to  be,  it  would 
be  impossible  to  take  care  of  him.  “You  will  have  to  get  him  a  good  home  some¬ 
where  through  the  Children’s  Home,  or  whatever  other  means  you  have  of  making 
such  arrangements.  I  am  awfully  sorry  that  we  cannot  under  the  circumstances 
do  anything  for  him,  and  if  he  goes  to  the  bad  I  would  feel  myself  responsible.” 

The  man’s  sister  was  made  of  other  clay.  None  of  her  family  would  join  her — 
“  I  stand  alone  as  far  as  my  family  are  concerned,  and  whatever  I  undertake  I 
must  try  and  be  equal  to.”  Nine  days  later  (the  wife  had  meanwhile  become 
violent  and  been  removed  to  an  insane  asylum)  comes  a  third  letter.  “  I  now  beg 
to  say  I  have  had  time  to  think  in  a  more  collected  way  and  come  to  better  con¬ 
clusions  than  when  I  wrote  you  at  first.”  Then  follow  instructions  as  to  just  how 
to  send  the  blind  man  and  his  little  son  to  her  home.  Two  weeks  later  the  sister 
writes  again,  “  I  think  it  only  courtesy  on  my  part  to  write  you  that  my  brother 
arrived  safely  in  due  time,  found  some  one  ready  to  assist  him  in  the  necessary 
changes,  and  is  now  comfortable.  The  little  boy  is  in  school  and  seems  to  be  rather 
a  desirable  child.  ...  I  would  think  as  I  observe  my  brother  that  it  will  be 
a  long  time  before  he  sees,  although  he  seems  to  be  very  hopeful.  He  has  a  good 
appetite,  and  says  he  rests  much  better  here  than  he  has  for  a  long  time.” 

Complaint  was  made  to  a  probation  department  about  a  girl  of  seventeen  by  her 
mother,  a  widow  whose  record  was  not  above  reproach.  The  probation  officer 
saw  the  paternal  Relatives,  and  was  much  impressed  by  the  two  aunts,  who  were 
far  more  careful  in  their  statements  than  “in-laws”  usually  are.  The  officer, 
realizing  the  seriousness  of  bringing  a  court  complaint  against  the  girl,  felt  that  the 

.  !3  193 


SOCIAL  DIAGNOSIS 


case  could  safely  be  left  with  these  Relatives,  and  told  them  so;  but  the  aunts  were 
rather  frightened  at  the  responsibility  and  said  that  they  did  not  know  how  to  talk 
to  their  niece.  The  officer  advised  them  to  “put  it  straight  up  to  her”  that  they 
had  heard  she  was  going  with  a  disreputable  man,  and  to  make  the  most  of  the 
affectionate  disposition  which  they  said  she  had.  They  succeeded  in  getting  from 
her  a  confession  and  a  promise  to  give  the  man  up.  The  probation  officer  con¬ 
tinues  to  make  suggestions,  but  has  not  had  to  appear  in  the  situation  in  any  way. 

With  reference  to  several  of  the  foreign  groups,  it  is  necessary  to 
bear  in  mind  that  godparents  hold  a  relation  to  the  family  quite 
as  close  as  that  of  Relatives,  and  that  their  co-operation  is  invalu¬ 
able.  In  their  own  country  the  ties  of  kinship — even  of  kindred 
not  nearly  related — are  close,  and  it  is  pitiful  to  see  the  dropping 
away  of  this  interest  and  sense  of  responsibility  wherever  America’s 
social  agencies  are  many  and  careless.1 

4.  Further  Considerations.  In  addition  to  the  importance 
of  Relatives  as  sources  of  interest  and  backing,  it  may  be  urged 
that  they  have  a  moral  right  to  be  considered — the  same  right, 
whenever  they  have  tried  to  do  their  duty,  that  any  church  or 
other  social  agency  interested  in  a  family  would  have  in  like  case, 
only  their  claim  is  somewhat  stronger  because  the  relation  is  more 
personal. 

Miss  Mary  I.  Breed  gives  an  instance  of  this:2  “One  experience  came  from  a 
woman  of  great  worth,  left  a  widow,  and  doing  her  best  to  support  her  two  boys. 
She  was  aided  generously  and  given  the  friendship  of  a  sympathetic  visitor.  Her 
family  were  not  seen,  because  of  her  claim  that  they  had  refused  all  help.  When 
she  developed  a  mental  malady  her  children  were  given  into  the  care  of  the  city  and 
then  an  agent  of  the  city  saw  the  woman’s  brother.  He  was  justly  incensed  that 
he  had  not  been  consulted  before,  as  he  had  been  both  able  and  willing  to  help. 
His  sister  had  been  alienated  from  her  family,  and  her  bitterness  toward  them  was  a 
part  of  her  mental  disease.” 

Moreover,  Relatives  are  themselves  a  part  of  the  community, 
potentially  a  helpful  part,  and  any  agency  interested  in  co-ordinating 
the  social  service  of  a  community  cannot  afford  to  leave  them  out. 

One  interesting  by-product  of  social  work  is  the  occasional  re- 

a, 

establishment  of  family  relationships  and  the  wearing  away  of 
misunderstandings. 

1  For  a  discussion  of  the  co-operation  of  Relatives  in  institutional  work  for  chil¬ 
dren  see  “Pittsburgh  as  a  Foster  Mother,”  by  Florence  L.  Lattimore,  in  The  Pitts¬ 
burgh  District,  Civic  Frontage,  p.  398  sq. 

2  In  one  of  the  short,  unpublished  papers  referred  to  in  the  Preface. 

194 


RELATIVES  AS  SOURCES 


Miss  Breed  gives  an  illustration  of  this  also:  “We  know  a  Jewish  widow  who, 
after  the  death  of  her  husband,  had  been  helped  most  generously  by  her  family 
until  they  lost  all  hope,  and  ceased  aiding  because  of  what  seemed  to  them  her 
incurable  laziness.  When  a  medical  diagnosis  showed  that  she  had  neurasthenia, 
and  when  a  set  of  teeth  and  a  long  course  of  good  food  and  fresh  air  had  made  her 
another  woman,  an  uncle  felt  so  contrite  for  his  past  neglect  that  he  set  her  up  in  a 
small  grocery  shop.” 

An  S.  P.  C.  C.  worker  was  applied  to  by  a  young  man  who  had  been  placed  out 
from  a  foundling  asylum  when  he  was  three  years  of  age.  Now  grown  and  doing 
well  in  a  farming  community,  he  wished  to  find  his  four  brothers.  Through  cor¬ 
respondence  with  the  foundling  asylum  and  the  town  clerk  of  the  community 
from  which  they  originally  came,  their  whereabouts  was  discovered,  one  of  them 
writing,  “  If  you  wanted  to  see  a  happy  young  lad,  you  ought  to  have  seen  me.  I 
sat  down  and  wrote  my  brother  a  nice  long  letter  of  eight  pages,  and  the  next 
Monday  I  got  an  answer  from  him  and  his  family’s  pictures.  He  wanted  me  to 
come  right  down.  ...  It  makes  a  fellow  feel  happy  to  know  he  is  not  alone 
in  the  world,  and  that  he  has  some  folks.” 

III.  QUESTIONS  OF  SUPPORT  FROM  RELATIVES 

Questions  of  support  (complete  or  partial)  from  Relatives  and 
of  temporary  relief  to  be  given  by  them  are  often  allowed  to  de¬ 
moralize  our  diagnosis  and  hamper  our  treatment.  Those  who 
turn  to  Relatives  for  nothing  but  material  things  are  unlikely  to 
use  them  wisely  for  even  this  one  object.  The  case  records  of 
public  departments  and  of  private  agencies  abound  in  such  penny- 
wise-and-pound-foolish  policies,  in  overemphasized  legal  responsi¬ 
bilities  and  underemphasized  social  opportunities. 

Responsibility  for  support  can  be  enforced  by  the  state,  which 
has  the  right  of  recovery  from  Relatives,  “  if  of  sufficient  ability,  ” 
in  the  direct  line  of  descent.  Support  laws  vary  in  the  different 
states,  but  quite  generally  the  two  parents  and  four  grandparents 
are  responsible  for  the  support  of  children,  and  children  who  have 
attained  their  majority  are  responsible  for  the  support  of  dependent 
parents  and  grandparents.1  Public  departments  and  institutions 
receiving  public  subsidies  are  often  very  careless  about  the  en¬ 
forcement  of  these  provisions.  When  they  bestir  themselves  to 
enforce  them  at  all,  they  tend  to  become  so  interested  in  the  finan- 

1  Children  are  definitely  held  responsible  in  35  states,  parents  in  32,  grandchildren 
in  22,  grandparents  in  20,  brothers  in  13,  and  sisters  in  12;  in  a  number  of  these 
states,  however,  responsibility  is  restricted,  in  cases  where  intemperance  or  other 
bad  conduct  is  the  cause  of  distress,  to  parents  and  children.  See  Summary  of 
State  Laws  relating  to  the  Dependent  Classes,  United  States  Census,  1913. 

195 


SOCIAL  DIAGNOSIS 


cial  side  of  their  relations  with  Relatives  that  they  refuse  to  inter¬ 
view  any  kindred  whose  responsibility  could  not  be  enforced  by 
law.  They  will  confer  with  sons  and  daughters,  parents  and  grand¬ 
parents,  that  is,  but  not  with  brothers  and  sisters,  uncles  and  aunts, 
nephews  and  nieces. 

An  associated  charities  record  of  a  homeless  man  shows  that  it  discovered  in  the 
first  month  of  acquaintance  with  him  facts  that  had  remained  unknown  for  sixteen 
years  to  the  public  insane  asylums  in  an  adjoining  state.  The  process  by  which, 
through  a  slender  clue,  his  people  were  found  in  a  third  state  is  described  in  another 
part  of  this  volume,1  but  the  point  to  be  made  here  is  that  the  failure  of  a  state's 
public  institutions  to  discover  this  man’s  family,  who  had  been  eager  for  news  of 
him  all  these  years,  is  not  so  much  a  failure  properly  to  adjust  a  question  of  legal 
support  as  it  is  a  far  graver  failure.  It  is  true  that  the  state  at  the  present  per 
capita  cost  of  maintenance  had  expended  $3,160  for  his  care,  but  it  had  done  some¬ 
thing  more  wasteful  than  this;  it  had  neglected  through  this  whole  period  to  utilize 
a  therapeutic  agency  of  the  first  importance.  The  man’s  family  proved  to  be  ster¬ 
ling  people,  whose  affection  and  sympathy  achieved  wonders  for  his  mental  health 
even  after  years  of  lost  opportunity.  The  man  had  been  a  runaway  from  the 
insane  hospital  when  he  applied  to  the  associated  charities;  he  was  discharged  and 
living  with  his  own  people  when  the  case  record  was  closed. 

A  record  from  a  public  department  shows  one  of  its  agents  journeying  from  end 
to  end  of  the  state  to  find  the  father  of  a  dependent  child  whose  mother  had  deserted 
it.  The  man  when  finally  found  explained  that  he  had  feared  to  make  inquiries 
because  of  the  wife’s  behavior.  He  has  since  been  paying  regularly  for  the  child’s 
support. 

Public  agencies  often  handle  questions  of  support  in  a  more 
perfunctory  way  than  this,  but  they  are  not  the  only  offenders; 
the  financial  side  is  too  much  dwelt  upon  by  private  agencies 
also,  both  in  the  earlier  consultations  with  Relatives  and  in  co¬ 
operation  with  them  throughout  the  period  of  treatment.  It  is 
undoubtedly  true  that  any  community  is  appreciably  poorer  in 
which  the  sense  of  family  solidarity  has  been  weakened  either 
through  carelessness  on  the  part  of  social  agencies  or  through 
sentimentality  among  the  well-to-do;  but  to  a  wooden  and  undis¬ 
criminating  enforcement  of  family  responsibilities  may  be  traced 
a  reaction  in  some  quarters  against  urging  any  who  are  not  com¬ 
fortably  off  to  care  for  their  own.2 

1  See  use  of  directories  in  Chapter  XIII,  Documentary  Sources,  p.  266  sq. 

2  See  correspondence  entitled  “A  Misplaced  Burden?”  in  Charities  and  the  Com¬ 
mons  for  Oct.  13,  1906,  p.  1 18,  in  which  Mrs.  Simkhovitch  protests  against  the 
“custom  of  calling  upon  relatives  for  support,  or  the  general  theory  that  families 
ought  to  have  pride  enough  to  look  after  their  own.  Where  there  is  some  member 

196 


RELATIVES  AS  SOURCES 


Questions  of  relief  and  of  support  are  an  important  but  always 
a  secondary  part  of  treatment.  The  social  worker  whose  technique 
has  more  than  one  dimension,  who  thinks  constructively  about 
the  cases  under  his  care,  is  not  likely  to  overlook  the  social  welfare 
of  each  reference  visited,  including  that  of  the  Relatives.  In  the 
case  cited  on  page  190  it  will  be  noted  that  Mrs.  Chesley  not  only 
refused  help  from  one  Relative  who  offered  it,  but  heartened  an¬ 
other  who  had  nothing  material  to  give  by  suggesting  a  different 
and  better  way  in  which  she  could  be  helpful.  The  relief  side  is 


of  the  family  amply  able  to  relieve  the  poverty  of  another  member,  it  seems  a 
natural  and  suitable  thing  to  expect  such  care.  But  when,  as  is  so  often  the  case, 
a  committee  of  some  powerful  charitable  society  with  large  resources  to  draw 
upon,  decides  in  a  given  instance  to  call  upon  a  struggling  relative  for  aid,  the  de¬ 
cision  cannot  but  strike  one  as  discreditable,  and  from  an  economic  point  of  view 
wasteful.” 

Miss  Zilpha  D.  Smith  presents  the  other  side:  “The  best  charity  workers  I 
know,  in  approaching  relatives,  go  to  ask  their  counsel,  their  co-operation,  to  offer 
an  opportunity  of  service;  and  they  are  so  frequently  rewarded  with  as  much  or 
more  than  they  expected,  even  from  relatives  said  to  be  unfriendly,  that  they  take 
pains  never  to  promise  not  to  communicate  with  a  relative.  There  may  be  occasions 
when  a  good  charity  worker  deems  it  best  to  delay  the  letter  or  the  interview,  but 
these  grow  fewer  as  experience  teaches  how  to  make  such  inquiries  with  sympathy 
and  discernment — to  learn  much  and  tell  little. 

“The  response  to  such  an  approach  usually  discloses  the  character  and  the 
resources,  financial  and  otherwise,  of  the  relative  and  his  attitude  toward  those  now 
in  need.  It  may  be  that  because  pride  or  resentment,  poverty  or  illiteracy  made 
communication  difficult,  they  have  allowed  the  family  acquaintance  to  weaken. 
Those  inquirers  who  go,  not  with  decision  already  made  as  to  what  the  relative 
ought  to  do,  but  to  talk  the  matter  over  with  an  open  mind,  do  not  find  as  Mrs. 
Simkhovitch  implies,  that  family  pride  is  the  chief  motive  which  brings  help  but 
rather  affection  and  loyalty  to  one’s  own,  the  traditions  and  memories  they  have 
in  common,  enhancing  ordinary  human  sympathy.  Even  if  the  charitable  society 
had  more  ample  resources  than  any  I  know,  it  could  not  afford  to  let  these  human 
values  go  to  waste. 

“When  it  is  pride  that  offers  help,  should  not  the  poor  man  choose  whether  he 
would  rather  part  with  his  pride  than  his  dollars?  If  a  friendly  interest  in  him,  as 
well  as  in  the  person  in  need,  continues,  it  will  be  possible  later  to  suggest  a  lessen¬ 
ing  of  the  burden,  if  that  is  wise.  A  state  superintendent,  whose  new  and  struggling 
institution  had  difficulty  in  getting  sufficient  appropriation,  nevertheless  undertook 
to  persuade  and  did  persuade  a  relative  to  cut  down  a  payment  of  $5.00  a  week  to 

“Not  only  those  in  want  feel  the  bitterness  of  the  burden  their  own  helplessness 
lays  upon  those  who  are  near  and  dear, — many  who  have  been  ill,  though  with 
money  enough  for  ordinary  needs,  have  felt  this  deep  sorrow.  But  there  is  an  ex¬ 
perience  even  more  bitter, — when  one  finds  himself  in  illness  or  in  want  and  there 
is  no  one  but  a  stranger  who  cares  enough  about  him  to  make  a  sacrifice. 

“  1  cannot  believe  that  many  charitable  societies  do  push  relatives  to  the  wall. 
My  observation  is  that  they  are  often  unwilling  to  take  the  trouble  to  consult 
relatives  unless  they  think  they  are  going  to  get  a  good  deal  of  money  out  of  them, 
not  realizing  what  a  great  advantage,  other  than  money,  the  practice  of  going  to 
them  brings.” 


197 


SOCIAL  DIAGNOSIS 


often  the  one  that  seems  most  important  to  the  Relative  we  are 
interviewing,  and  we  must  aim  to  interest  him  in  the  other  aspects, 
to  carry  his  mind  beyond  a  justification  of  his  own  position,  more¬ 
over,  to  a  consideration  of  the  other  person’s  difficulty  in  and  of 
itself.  The  following  are  examples  of  a  less  flexible  method.  They 
show  some  of  the  weaknesses  of  our  present  practice,  and  emphasize 
the  importance  of  keeping  constructive  treatment  always  in  view. 

\ 

A  charity  organization  society  was  asked  to  befriend  a  family  in  which  the  man 
was  out  of  work  and  beginning  to  keep  bad  company  and  the  woman  was  expecting 
her  second  child  in  a  few  weeks.  Both  of  the  man's  brothers  were  written  to  in  the 
following  vein:  “Your  brother  (giving  name  and  address)  has  been  out  of  work  for 
a  number  of  weeks  and  his  family  have  got  behind  in  their  expenses.  They  owe  $16 
rent  and  a  store  bill  of  about  $12.  His  wife  is  unable  to  help  with  the  income  owing 
to  her  present  condition.  She  expects  to  be  confined  next  month.  Will  it  not  be 
possible  for  you  to  help  your  brother  and  his  family  until  he  is  again  on  his  feet?” 
Not  only  the  further  developments  in  this  case  but  the  situation  as  revealed  in  the 
first  interview  pointed  to  the  need  of  insight  into  the  man’s  character,  work  rela¬ 
tions,  domestic  relations,  health,  etc.  His  two  brothers  would  also  have  been  better 
witnesses  than  he,  perhaps,  to  the  size,  whereabouts,  and  resources  of  the  whole 
family  connection,  but  the  two  letters  were  not  answered.  In  all  probability  this 
lack  of  response  was  due  to  too  early  emphasis  upon  the  matter  of  relief. 


The  subject  of  letters  of  inquiry  is  treated  in  a  separate  chapter,1  but  it  may  be 
well  to  cite  here  another  letter  which  brought  no  reply;  it  was  addressed  to  a  young 
man’s  father  by  a  charity  organization  society.  After  stating  the  condition  of 
distress  in  which  the  son  and  his  wife  and  his  two  children  were  found,  the  letter 
continues,  “We  should  be  glad  of  information  in  regard  to  man’s  previous  record 
and  your  idea  as  to  his  ability  to  take  care  of  his  family.  This  information  will  be 
considered  confidential  if  you  desire  it.  Would  you  feel  inclined  to  assist  the  family 
financially,  provided  Mr.  J  makes  every  effort  to  get  employment?”  Here  the 
error  is  a  double, one;  financial  assistance  is  led  up  to  as  the  climax;  “previous 
record,”  “man,”  and  “the  family”  are  technical,  non-human  terms  in  what  should 
have  been  a  very  human  document. 

Comment  upon  an  Italian  record  submitted  for  study  includes  a  reference  to 
support  questions.  The  man  of  the  family  had  attempted  to  assault  his  own  daugh¬ 
ter  at  one  time  when  he  was  drunk  and  had  been  shot  by  one  of  his  sons,  who  was 
trying  to  protect  the  girl.  The  charity  organization  society  did  faithful  work  later 
to  improve  the  broken  health  of  thh  father  and  to  befriend  his  better-grade  wife. 
The  two  older  sons  entered  the  United  States  Navy  and  were  induced  by  the 
society,  in  co-operation  with  the  government,  to  send  part  of  their  pay  home.2 

1  Chapter  XVII,  Letters,  Telephone  Messages,  etc. 

2  A  circular  letter  addressed  by  one  of  the  United  States  Naval  Training  Stations 
“to  the  parents  of  apprentice  seamen”  reads  in  part:  “The  Commanding  Officer 
has  no  authority  other  than  to  advise  a  man  under  his  command  as  to  sending  money 

198 


RELATIVES  AS  SOURCES 


The  commentator  says,  “You  are  following  the  orthodox  view,  of  course,  in  en¬ 
couraging  the  United  States  to  get  half  pay  out  of  Giorgio  and  Giovanni.  All 
the  back  family  history  may  have  had  the  effect  of  simply  embittering  them, 
though,  and  making  them  feel  that  this  additional  demand  is  part  of  the  general 
injustice  of  living.  Giovanni’s  letter  gives  a  hint  of  this,  and  Giorgio  is  stationed 
near  enough  to  your  city  for  you  to  learn  at  first  hand,  perhaps,  his  theory  of  things. 
I  do  not  mean  that  the  payments  should  stop,  but  I  wish  that  they  might  be  made  a 
part  of  plans  worked  out  with  these  young  men  for  saving  the  younger  children  from 
the  awful  mill  that  the  older  ones  have  been  through.” 

Comment  upon  another  Italian  case  record  reads  as  follows:  “One  outside  visit 
was  made;  namely,  to  the  sister  who  had  furnished  transportation.  It  brings,  for 
result,  the  one  item  that  the  ‘sister  can  do  no  more.’  Presumably  she  was  asked  to 
relieve,  or  this  idea  was  allowed  to  get  in  the  foreground.  .  .  .  Here  was  a 

sister  able  on  relatively  short  notice  to  transport  two  adults  and  seven  children  from 
Italy — evidently  a  person  of  some  resource.  ...  I  am  advocating  not  a 
demand  for  relief  from  this  relative,  which  brings  almost  inevitably  a  negative 
response,  but  an  approach  that  would  have  brought  out  her  knowledge  of  the  old 
life  on  the  other  side,  of  the  shop  and  the  home  and  the  daily  happenings,  together 
with  the  names  of  the  other  relatives  that  had  come  over  from  time  to  time.  De¬ 
cidedly,  those  who  lean  heavily  upon  the  modern  child  welfare  devices,  as  against 
the  old  devices  of  uncles  and  aunts  and  parental  responsibility,  make  a  pitiful 
showing  sometimes — they  do  in  this  family,  where,  thus  far,  the  health,  the  school¬ 
ing,  and  the  industrial  start  of  these  children  have  been  hampered  by  the  lack  of 
history  which  the  relatives  could  easily  have  supplied.” 

These  criticisms  of  a  method  that  thrusts  relief  into  undue 
prominence  must  not  be  taken  as  implying  that  the  enforcement  of 
financial  responsibility  upon  Relatives  is  foolish.  Often  the  mere 
enforcement  brings  with  it  wholesome  social  readjustments.  In 
cases  of  family  desertion,  for  instance,  the  throwing  of  the  resulting 
relief  burden  upon  the  man's  people,  when  they  are  well  able  to 
bear  it  and  when  there  is  reason  to  believe  that  they  know  his 
whereabouts,  has  been  found  to  hasten  his  return.  Some  social 
reformers  have  taken  the  position  that  Relatives  will  be  more 

home.  Encouragement  to  do  so,  however,  is  given,  and  on  simple  request,  provided 
the  amount  is  available  on  the  books,  and  the  object  seems  worthy,  the  pay  officer 
issues  a  check  for  the  amount  requested,  and  charges  it  to  his  account.  Until  after 
two  months  at  this  Station,  an  apprentice  seaman  has  very  little  money  available, 
hence  little  may  be  expected  until  after  that  time.  Later,  after  transfer  to  a  sea¬ 
going  ship,  any  man  has  the  privilege  of  alloting  a  part  of  his  pay  to  his  home;  that 
money  is  drawn  through  the  mails  each  month,  by  the  person  to  whom  it  is  allotted, 
and  without  regard  to  any  further  request  on  the  part  of  the  allotter.”  A  letter 
from  the  commandant  at  this  T raining  Station  adds,  in  further  explanation :  “  When 
we  are  informed  that  the  parents  of  one  of  our  young  men  are  in  needy  circumstances 
and' need  the  help  in  a  financial  way  of  the  recruit,  our  policy  is  to  interview  the  lad 
and  endeavor  to  impress  upon  him  his  responsibilities  in  the  matter.” 

199 


SOCIAL  DIAGNOSIS 


interested  in  the  welfare  of  their  less  fortunate  kindred  when  the 
state,  relieves  them  of  all  sense  of  financial  obligation.  If  this 
position  prove,  after  experiment,  to  be  psychologically  sound,  it 
will  reverse  the  judgments  of  both  educators  and  social  workers. 

IV.  METHODS  OF  APPROACH 

For  merely  objective  matters  of  fact,  those  sources  of  information 
which  are  the  most  impersonal  are  the  most  satisfactory.1  But 
Relatives  are  of  all  sources  the  least  impersonal;  and,  for  this 
reason  perhaps,  we  find  them  difficult  witnesses.  Most  social 
workers  realize  the  importance  of  Relatives,  and  also  the  difficulty 
of  interviewing  them  for  the  first  time.  Next  to  the  first  interview 
with  the  client  himself,  here  is  the  greatest  danger  of  a  false  start, 
with  the  added  danger,  moreover,  of  making  trouble  between 
kindred.  A  social  worker  with  only  one  year's  experience,  but 
with  a  natural  gift  for  helpful  relations  with  people,  writes  in 
answer  to  a  question,  “In  three  cases  in  particular,  I  interviewed 
relatives  when  I  was  almost  convinced  myself  that  more  harm  than 
good  would  be  done.  Yet  in  two  of  those  cases  breaches  of  years' 
standing  were  healed,  and  in  the  other  I  obtained  information  that 
made  all  the  difference  in  the  world  in  dealing  with  that  family. 
That  harm  is  not  more  often  wrought  by  the  visits  of  the  social 
worker  in  quest  of  information  and  co-operation  seems  to  me  to  be 
due  to  the  fact  that,  if  properly  approached,  relatives  are  not  apt 
to  question  her  right  to  such  a  deep  interest  in  the  family,  and  with 
an  almost  unnatural  frankness  open  their  hearts  to  utter  strangers. 
If  I  remember  aright,  I  have  had  only  one  actual  rebuff  this  winter 
and  half  an  apology  was  afterwards  made  for  that  by  another 
member  of  the  family." 

“  If  properly  approached."  No  mere  instructions  can  be  of 
any  value  here.\To  be  really  interested,  to  be  able  to  convey  this 
fact  without  protestations,  to  be  sincere  and  direct  and  open- 
minded — these  are  the  best  .keys  to  fruitful  intercourse.  When 
a  worker  comes  back  again  and  again  with  the  statement  that  the 
Relatives  do  not  know  or  will  not  tell,  he  has  probably  mislaid 
or  never  had  some  one  of  these  keys. 

Information  of  how  much  the  Relatives  have  done  already  comes 
1  This  idea  is  developed  in  Chapter  XIII,  Documentary  Sources. 

200 


RELATIVES  AS  SOURCES 


with  a  word,  and  their  reasons  for  being  seriously  displeased  are 
proffered  easily.  It  is  true  that  too  often  they  have  been  much 
put  upon.  Listen,  get  their  point  of  view,  remember  that  even 
the  irrelevant  things  that  they  say  will  help  you  to  estimate  their 
value  as  witnesses,  then — push  beyond  to  the  things  that  more 
immediately  concern  your  client,  being  careful  to  seek,  even  here, 
only  those  items  of  evidence  that  each  particular  Relative  seems 
fitted  to  give.  Confer  with  them  about  the  possibilities  already 
in  mind.  “  Relatives  are  often  indignant  to  find  we  have  made  a 
pretence  of  consulting  them  merely  to  foist  upon  them  our  own 
plan/’  The  consultation  must  be  genuine.  Sometimes  their  own 
resourcefulness  puts  ours  to  shame. 

After  a  number  of  Relatives  have  been  seen,  their  plans  may 
conflict  or  their  adherence  to  any  one  plan  of  action  may  be  half¬ 
hearted.  In  that  case  it  may  be  well  to  follow  up  the  separate 
interviews  by  arranging  a  conference  with  all  of  them  together. 
This  makes  for  clearness  of  understanding  and  dignifies  their  part 
in  the  treatment  that  is  to  follow. 

The  approach  to  Relatives  is  made  more  difficult  sometimes  by 
the  fact  that  the  social  worker  is  the  bearer  of  bad  news. 

An  S.  P.  C.  C.  was  notified  by  a  day  nursery  of  a  mother’s  serious  neglect  of  her 
young  baby.  The  woman  was  only  twenty-one,  had  come  to  the  city  to  study  at  a 
technical  school,  and  was  receiving  money  regularly  for  this  purpose  from  her  pa¬ 
rents  in  another  state.  They  knew  nothing  of  her  illegitimate  child  or  of  her  mar¬ 
riage  to  its  father  three  months  after  its  birth.  The  society  wrote  as  follows: 

“We  have  been  interested  for  some  little  time  in  the  welfare  of  your  daughter, 

Mrs.  - ,  and  her  daughter,  Ethel,  and,  on  account  of  the  neglect  of  the 

child’s  parents,  the  Judge  of  the  Juvenile  Court  has  placed  the  child  temporarily 
with  a  state  agency.  We  might  have  allowed  this  matter  to  go  on  without  bringing 
it  to  your  attention,  but,  at  the  request  of  the  Judge,  who  has  dealt  in  a  most  kindly 
way  with  your  daughter,  we  are  asking  you  to  come  to  her  assistance  and  to  save 
her  from  the  degradation  to  which  she  now  seems  destined  unless  those  who  are 
most  concerned  about  her  can  work  vigorously  for  her  redemption.  Instead  of 
going  into  the  details,  we  should  like  to  ask  whether  you  or  your  wife  or  both  could 
not  come  to  this  city  and  consult  with  us  or  send  some  one  equally  interested  to 
represent  you  with  whom  the  whole  matter  can  be  talked  over.’’ 

Two  days  later  the  girl’s  father  appeared  and  her  mother  soon  after — simple 
country  people  and  both  very  helpless.  But  another  daughter  of  the  family  proved 
to  have  the  necessary  strength  of  character.  She  was  given  the  legal  guardianship 
of  the  child,  and  mother  and  child  went  back  later  to  tjie  country  home. 

201 


SOCIAL  DIAGNOSIS 


The  effort  to  get  in  direct  communication  with  these  particular 
Relatives,  not  trusting  to  letters  only  in  so  delicate  a  matter,  was 
prompted  by  a  sound  instinct.  Relatives  are  often  at  such  a 
distance  that  personal  interviews  are  impossible,  however,  and 
this  is  especially  true  in  the  United  States,  where  frequent  migra¬ 
tions  within  the  large  cities,  and  migrations  from  county  to  county 
or  state  to  state  make  our  communications  with  Relatives  at  once 
more  difficult  and  more  necessary.1  Immigration  is  a  further  com¬ 
plication.  It  has  been  said  that  many  of  our  social  clues  run  into 
the  Atlantic  Ocean,  thus  compelling  us  to  communicate  indirectly 
through  mayors,  consuls,  etc.,  in  other  countries. 

SUMMARY  OF  THIS  CHAPTER 

1.  The  statements  of  this  chapter  do  not  apply  to  Relatives  in  the  immediate 
family  of  a  client,  but  include  all  others  whether  related  by  birth,  by  marriage,  or 
by  descent. 

2.  It  is  necessary  to  keep  in  mind  in  all  our  contacts,  however,  the  distinction 
between  relationship  by  birth  or  descent,  and  relationship  by  marriage,  for  the  latter 
is  associated,  often,  with  a  peculiar  type  of  prejudice. 

3.  Discrimination  must  be  used  as  to  which  Relatiyes  to  see  and, when;  they 
should  not  be  seen  to  the  exclusion  of  other  important  sources.  It  is  possible  also 
to  overestimate  the  claims  of  kindred,  irrespective  of  character,  habits,  or  circum¬ 
stance. 

4.  The  chief  failings  of  Relatives  as  witnesses  are  (1)  their  prejudice,  (2)  their 
assumption  that  they  know  more  than  they  really  do,  (3)  their  lack  of  understand¬ 
ing  of  a  social  situation  and  of  social  values. 

5.  On  the  other  hand,  differential  diagnosis  and  treatment  would  be  sadly  im¬ 
poverished  without  their  characteristic  contributions  of  (1)  individual  and  family 
history,  (2)  insight,  (3)  backing  and  active  co-operation. 

6.  Aside  from  their  ability  to  serve,  Relatives  have  a  moral  right  (whenever  they 

have  tried  to  do  their  duty,  that  is)  to  be  consulted.  Our  consultations  with  them 
should  be  genuine;  they  should  be  given  a  chance  to  aid  in  shaping  our  social  poli¬ 
cies,  instead  of  having  plans  of  treatment  imposed  upon  them  ready-made  from  with¬ 
out.  ^ 

1  In  a  study  of  the  thirteen-year-old  boys  in  the  city  schools  of  78  American  cities 
(places  of  between  25,000  and  200,000  inhabitants)  it  was  found  that  only  one  in 
six  of  the  fathers  of  these  boys  was  living  in  the  city  of  his  birth,  and  that  among 
the  boys  themselves,  only  a  few  more  than  half  were  living  where  they  were  born. 
Of  the  fathers  40  per  cent,  of  the  boys  9  per  cent  were  foreign  born;  but  the  migra¬ 
tion  of  44  per  cent  of  the  fathers  and  33  per  cent  of  the  boys  was  within  the  United 
States.  See  Some  Conditions  Affecting  Problems  of  Industrial  Education  in  Sev¬ 
enty-eight  American  School  Systems,  by  Leonard  P.  Ayres.  Pamphlet  of  the 
Division  of  Education,  Russell  Sage  Foundation,  1914. 


202/ 


RELATIVES  AS  SOURCES 


7.  Responsibility  for  support  from  near  Relatives  can  be  enforced  by  the  state. 
Public  social  agencies  charged  with  the  administration  of  support  laws  often  fall 
ip1;o  the  error  of  ignoring  the  other  and  higher  services  that  Relatives  could  render. 
Private  agencies  make  a  similar  mistake  when  they  approach  Relatives  with  the 
sole  object  of  procuring  relief.  It  does  not  follow,  however,  that  Relatives  should 
be  relieved  of  any  financial  responsibility  that  they  can  bear  without  endangering 
their  own  social  welfare. 


•v 


203 


CHAPTER  X 


MEDICAL  SOURCES 

IF,  ON  the  basis  of  the  social  case  work  records  then  available 
for  study,  this  book  had  been  written  fifteen  years  ago,  it 
would  probably  have  been  found  that  the  outside  source  of 
information  consulted  oftener  than  relatives  even  was  employers. 
But  there  has  been  a  shifting  of  interest  from  data  abourbafmngs 
and  occupation  to  data  about  health  and  disease.  All  of  these 
groups  of  facts  are  closely  interrelated,  of  course,  and  the  change  is 
merely  one  of  emphasis.  So  marked  is  it,  however,  that  there  may 
be  need  later  of  new  emphasis  upon  another  group  of  sources  to 
preserve  our  social  center  of  gravity. 

The  lists  of  outside  sources  used  by  the  56  social  agencies  whose 
records  were  studied  show  that  Medical  Sources  were  consulted 
two  and  a  half  times  as  often  as  employers  and  other  work  sources. 
In  2,800  cases,  to  be  exact,  1,828  Medical  Sources  were  consulted 
and  743  work  sources.1  The  multiplication  in  recent  years  of 
medical  agencies  both  curative  and  preventive,  especially  in  large 
cities  like  those  included  in  our  study  of  sources,  accounts  in  part 
for  this;  in  part,  it  is  due  to  the  fact  that  some  agencies  for  the 
care  of  the  sick  now  have  social  as  well  as  medical  records — social 
records  that  can  be  consulted  with  profit,  that  is.  But  part  of  it  is 
also  due  to  a  change  in  the  attitude  of  non-medical  social  workers 
toward  their  own  task.  In  seeking  to  remedy  bad  social  conditions 
they  have  come  to  recognize  more  fully  the  great  handicap  of  bad 
physical  conditions,  and  have  learned  to  welcome,  in  the  effort  to 
remedy  these,  the  aid  of  a  newer  and  more  constructive  medical 
science.  Their  awakening  is*  due,  in  part,  to  their  own  deepened 
experience  of  human  need,  but  even  more  is  it  due  to  the  socialized 
members  of  the  medical  profession,  who  have  led  the  way  in  many 
departments  of  social  endeavor — a  way  in  which  the  lay  social 
workers  have  been  only  too  glad  to  follow. 

1  See  Appendix  II,  Table  A. 

204 


MEDICAL  SOURCES 


The  kinds  of  Medical  Sources  most  often  consulted  by  the  56 
agencies  were  physicians,  hospitals  and  sanatoria,  dispensaries, 
medical-social  service  departments,  nurses,  and  public  health  de¬ 
partments.  It  must  be  conceded  that  social  workers  have  been 
handicapped,  often,  in  their  use  of  these  sources  of  information  by 
their  lack  of  knowledge  of  even  the  most  elementary  facts  about 
disease  and  by  their  lack  also  of  understanding  of  the  organization 
and  discipline  necessary  in  a  hospital  or  dispensary.  But,  as  these 
pages  are  an  attempt  to  estimate  the  social  value  of  the  various 
sources  of  evidence,  and  as  the  case  records  studied  show  not  only 
the  great  serviceableness  but  the  occasional  failure  of  Medical 
Sources,  it  may  be  well  to  follow  the  plan  already  followed  in  the 
chapter  on  Relatives  and  illustrate  these  failures  at  once,  even  at 
the  risk  of  seeming  to  overemphasize  them.  It  will  be  evident  a 
little  later  that  much  more  can  be  said  on  the  other  side. 

I.  WHERE  MEDICAL  EVIDENCE  SOMETIMES  FAILS 

Case  notes  under  this  head  made  in  the  course  of  our  extended 
case  reading  tell  their  own  story  of  (1)  a  non-social  attitude,  (2) 
conflicting  diagnoses  and  prognoses,  and  (3)  faulty  medical  records. 

1.  Non-social  Attitude.  Let  two  illustrations  suffice.  It  may  be 
that  both  show  poor  medical  work  also,  but  the  writer  makes  no 
attempt  to  pass  judgment  upon  their  medical  aspects: 

A  child-saving  agency  found  a  little  girl  of  seven  in  a  boarding  house  where  she 
had  been  placed  by  her  mother,  a  waitress.  This  mother  was  described  as  “suspi¬ 
cious,  quarrelsome,  and  altogether  difficult.”  Her  child  was  illegitimate.  The  little 
thing’s  eyes  were  seriously  inflamed,  her  whole  face  swollen,  eruption  behind  ears 
and  on  scalp;  she  had  been  in  this  condition  for  two  months,  often  seen  by  mother, 
but  no  medical  care  procured.  The  public  health  department  had  diagnosed  the 
child’s  condition  as  syphilitic  five  years  earlier.  The  mother  was  persuaded  by  the 
society  to  permit  them  to  place  the  patient  in  a  hospital,  the  hospital  authorities 
agreeing  to  report  to  the  society’s  agent  a  few  days  before  discharge.  Later  the 
hospital  reported  that  the  child  had  been  discharged,  at  the  request  of  the  mother’s 
physician,  or  at  the  request  of  someone  representing  himself  as  such  over  the  tele¬ 
phone.  Only  the  last  name  of  this  physician  was  known  at  the  hospital. 

On  complaint  of  a  commission  for  the  blind,  a  physician  was  prosecuted  by  an 
S.  P.  C.  C.  for  failing  to  report  a  case  of  ophthalmia  neonatorum.  The  eyes  of  a  six- 
weeks-old  baby  had  been  irreparably  injured  by  this  disease.  The  physician  em¬ 
ployed  was  fined  $50  and  appealed  the  case.  Among  other  witnesses  for  the  prose¬ 
cution  was  an  eye  infirmary.  A  copy  of  the  prosecuted  doctor’s  letter  to  the  board 
of  health  was  also  entered  in  evidence  against  him. 

205 


SOCIAL  DIAGNOSIS 


None  feel  the  results  of  these  non-social  acts  or  of  failures  to 
co-operate  with  social  workers  more  keenly  than  do  the  more  pro¬ 
gressive  of  the  physicians  themselves.  There  is  marked  advance 
every  year  among  these  latter  in  the  development  of  a  deeper  social 
concern. 

2.  Conflicting  Diagnoses  and  Prognoses.  These  often  delay 
social  work  very  seriously,  just  as  conflicting  plans  of  social  treat¬ 
ment  must  hamper  medical  work.  Some  of  this  delay  is  inevitable, 
for  medicine  is  an  experimental  science,  but  in  all  probability  some 
of  it  is  due  to  unevenness  in  the  standards  of  medical  practitioners, 
and  some  unquestionably  js  due  to  the  uneven  development  just 
referred  to  in  the  medical  profession’s  sense  of  social  responsibility. 
A  society  for  protecting  children  from  cruelty  finds  that,  when  it 
brings  a  physician  into  court  to  testify  to  certain  conditions,  the 
defendant  in  the  case  can  usually  find  some  other  doctor  to  swear 
that  the  facts  are  just  the  reverse. 

In  one  case,  a  tubercular  mother  had  been  reported  to  a  child-saving  agency  because 
she  refused  to  allow  her  six-year-old  crippled  son  to  go  to  a  school  for  cripples.  The 
boy  was  sleeping  with  his  mother,  and  one  of  the  physicians  at  a  certain  children’s 
hospital  said  that  the  child  could  make  no  progress  if  left  at  home.  A  settlement 
nurse  and  the  family  physician  reported  that  the  mother  was  careless  and  was  likely 
to  infect  her  children.  A  board  of  health  doctor  objected  to  home  surroundings  and 
advised  sending  the  child  away.  In  court,  however,  the  family  was  able  to  produce 
a  letter  from  a  second  physician  at  the  same  children’s  hospital,  objecting  strongly 
to  the  removal  of  the  child,  as  his  disease  was  incurable,  and  adding,  “We  are  willing 
to  give  the  mother  advice  and  help  whenever  it  is  necessary.”  This  was  further 
reinforced  by  another  medical  institution,  the  nurse  from  which  reported  a  well-kept 
home. 

The  following  memoranda  summarize  the  various  diagnoses  and  treatments 
advised  in  one  case  that  was  under  the  care  of  a  hospital  social  service  department: 
Oct.  31.  Girl  aged  sixteen,  pretubercular,  needs  a  country  home.  Nov.  13.  Tuber¬ 
cular.  Too  hysterical  to  go  to  a  hospital;  must  be  treated  at  her  own  home,  where 
medical  supervision  will  be  constant  and  expert.  Dec.  11.  Operation  advised  for 
ovarian  cyst.  Not  tubercular;  hospital  care.  Feb.  8  of  the  following  year.  En¬ 
tirely  well,  needs  nourishing  food  before  she  commences  work.  Apr.  18.  Tubercu¬ 
losis,  first  stage.  Sanatorium  advised.  Jan.  28,  year  succeeding.  Patient  quite 
well.  Reported  not  to  have  gone  to  a  sanatorium.  Apr.  18.  Major  hysteria;  needs 
long  care  in  hospital. 

The  uncertainties  of  prognosis  scarcely  need  illustration. 

A  charity  organization  society  was  caring  for  a  wife  and  five  children  while  the 
husband  was  in  a  hospital.  On  March  8,  hospital  reports  man  may  have  to  remain 

206 


MEDICAL  SOURCES 


two  weeks  longer,  and  that  it  may  be  a  month  before  he  is  able  to  work.  His  trouble 
is  sciatica;  there  is  nothing  that  can  be  done  for  it  except  to  see  that  man  has 
absolute  rest.  April  12,  hospital  reports  that  man  has  tuberculosis  of  the  spine; 
will  not  be  able  to  work  for  at  least  six  months,  possibly  mom.  May  8,  hospital 
reports  at  present  man  has  not  tuberculosis  of  the  spine;  the  trouble  he  is  being 
treated  for  is  sciatica  and  he  seems  to  be  responsive  to  treatment.  If  he  continues 
to  improve  he  will  probably  leave  the  hospital  soon. 

In  an  Italian  family  already  mentioned  in  another  coiinection1  there  were  several 
medical  diagnoses — three  of  the  father  of  the  family  (who  had  had  facial  paralysis, 
apparently,  after  he  had  been  shot  in  the  jaw),  one  diagnosis  of  the  son-in-law,  and 
none,  though  one  was  needed,  of  the  daughter,  aged  sixteen.  A  commentator  adds: 

“  I  realize  that  delay  is  accounted  for  by  the  contradictory  diagnoses  of  Mr. - ’s 

condition.  The  doctors  are  as  fallible  as  we  are,  and  we  must  expect  to  lose  time 
while  they  are  finding  out  what  to  do.” 

It  should  be  repeated  that  the  faults  of  social  reports  to  physi¬ 
cians  are  quite  as  grave  as  any  faults  here  noted  in  medical  reports. 
“  I  have  seen  many  examining  physicians  discouraged/'  writes  the 
head  of  a  medical-social  service  department,  “by  the  poverty  of 
social  workers'  reports,  which  are  so  increasingly  important  to  a 
proper  clinical  examination  and  diagnosis  of,  for  instance,  a  feeble¬ 
minded  child." 

3.  Faulty  Medical  Records.  Some  conflicting  diagnoses  and 
prognoses  could  probably  be  traced  to  failures  in  the  original 
records,  or  to  failures  in  their  interpretation  by  custodians.  Dis¬ 
pensary  records  would  seem,  from  our  case  reading,  to  be  far  less 
dependable  than  hospital  ward  records,  though  there  are  notable 
exceptions  to  this.  An  extreme  instance  of  faulty  method  would  be 
that  of  the  dispensary  which  could  never  identify  a  patient  or  his 
record  by  name,  age,  and  address,  but  always  added,  after  its  gen¬ 
eral  disclaimer  of  any  previous  knowledge,  “Tell  him  to  come  and 
bring  his  bottle,  and  then  we'll  know."  Past  medical  history  is 
often  of  such  medical  as  well  as  social  importance  that  dispensaries 
which  attempt  to  keep  records  at  all  are  surely  justified  in  keeping 
them  in  such  a  way.  as  to  identify  the  patient  recorded. 

II.  COMPLEMENTARY  NATURE  OF  MEDICAL  AND  OF  SOCIAL 

DATA 

The  discovery  of  the  possible  assistance  of  social  history  in  the 
medical  field  is  so  relatively  new  that  there  is  smalH^onder  to  find 

1  See  p.  198. 

207 


SOCIAL  DIAGNOSIS 


it  used  awkwardly  on  both  sides  as  yet.  Two  examples  found  in  a 
group  of  hospital  social  service  records  illustrate  the  complementary 
nature  of  medical  and  of  social  data.  Each  is  an  instance  of  mis¬ 
taken  diagnosis  in  its  own  field,  corrected  by  evidence  from  the 
other  field  later. 

A  physician  referred  a  woman  of  twenty-six  to  the  social  service  department  for 
a  pelvic  disturbance  needing  home  supervision  and  treatment.  A  home  visit  brought 
out  a  history  of  convulsions  up  to  the  age  of  twelve,  and  morning  “spells”  to  the 
present  time.  Re-examination  in  the  nerve  clinic  followed,  with  the  result  that  the 
patient  is  now  in  an  institution  for  epileptics. 

The  other  side  is  illustrated  by  a  diagnosis  of  insanity  made  in 
a  dispensary. 

The  patient  in  question  had  been  reported  to  an  S.  P.  C.  C.  for  maltreating  her 
children  when  in  drunken  rages.  Unable  to  discover  any  trace  of  alcoholism  the 
society  had  dropped  the  complaint.  At  the  dispensary,  the  woman  confessed  to 
the  fear  that,  in  acute  attacks,  she  had  abused  her  children.  The  S.  P.  C.  C.  could 
have  protected  the  children  if  the  mother’s  mental  disturbance  had  been  discovered 
earlier. 

The  complementary  nature  of  the  two  fields  of  work  is  well 
illustrated  by  the  difference  between  prescribing  braces  or  other 
apparatus  and  securing  their  proper  use.  A  critic  of  the  case 
record  of  an  Italian  family  referred  to  on  the  preceding  page  wrote 
to  the  social  worker  responsible  for  their  treatment: 

1  distinctly  question  the  wisdom  of  putting  on  your  blank  forms  of  inquiry 
addressed  to  doctors  of  dispensaries  the  following  question:  Does  patient  need  care 
which  dispensary  cannot  give?  The  psychological  effect  of  blank  space  after  a 
printed  question  is  to  suggest  the  filling  in  of  the  answer,  whether  the  writer  has 

one  or  not.  This  may  not  have  been  the  case  with  Dr. - ,  but  his  prompt  filling 

in  of  the  Taylor  brace  led  to  an  equally  prompt  ordering  of  it  without  any  considera¬ 
tion  whatever  of  the  son-in-law’s  willingness  to  wear  it  or  ability  to  get  any  good 
out  of  it.  The  son-in-law  got  in  a  huff  and  returned  the  brace  later,1  which  only 

1  This  brings  to  mind  a  passage  in  Dr.  Richard  Cabot’s  address  at  the  National 
Conference  of  Charities  and  Correction  (Baltimore)  in  1915:  “In  the  orthopedic 
clinic  of  the  Massachusetts  General  Hospital  we  treat  cases  of  spinal  curvature. 
They  are  often  aided  by  the  application  of  a  plaster  jacket  which  forces  the  deformed 
chest  gradually  back  into  something  like  correct  position.  It  seems  like  a  simple 
mechanical  problem.  But  it  isn’t,  for  there  are  people  who  will  wear  a  plaster  jacket 
and  there  are  people  who  won’t.  To  make  these  jackets  costs  something;  hence  the 
social  workers  in  that  clinic  are  now  trying  to  find  out  in  advance  what  people  will 
wear  plaster  jackets  and  what  people  won’t,  as  it  does  not  pay  to  apply  plaster 
jackets  to  people  who  won’t  wear  them.  If  there  is  any  field  for  psychological 
study  less  promising  than  the  problem  of  spinal  curvature,  I  do  not  know  it.  Yet 
we  have  obtained  already  a  rich  harvest  there.” — Proceedings,  p.  224. 

208 


MEDICAL  SOURCES 


shows  what  a  child  you  had  to  deal  with.  The  other  social  agencies  should  stand 
behind  the  medical  agencies,  and  do  their  best  to  get  people  well,  whether  by  relief 
or  by  other  treatment,  but  the  question  and  answer  in  this  particular  case  threw 
the  relief  out  of  perspective.  It  would  be  interesting  to  trace  the  actual  results  in 
individual  cases  of  a  generous  “handing  out”  of  diets,  appliances,  etc.,  on  the  order 
of  doctors  and  nurses  who  were  given  to  understand  that  all  they  needed  to  do 
in  order  to  get  was  to  ask. 

Another  medical  aspect  of  this  case  which  seems  to  have  been  overlooked  is 
the  statement  by  Mrs.  E  that  Concetta  is  “not  quite  normal.”  This  is  made  in 
February  and  repeated  in  March  in  a  letter  to  the  doctor.  Work  had  been  found 
for  Concetta  previously  and  work  was  urged  for  her  later.  Her  heredity  and  earlier 
history  suggest  the  need  of  a  most  careful  physical  and  mental  examination. 

It  is  evident  that  both  groups  of  public  servants — the  social  and 
the  medical — will  serve  the  public  best  when  they  have  thoroughly 
mastered  in  all  its  details  the  technique  of  working  together.  The 
following  examples  of  the  kinds  of  report  that  have  proved  helpful 
from  one  group  to  the  other  may  further  illustrate  relations  be¬ 
tween  the  two: 

A  charity  organization  society  was  interested  in  a  family  in  which  the  father  had 
tuberculosis,  the  mother  was  sick  also,  and  there  were  two  children  at  home.  The 
father  was  sent  to  the  country.  The  doctor  who  examined  the  mother  made  a 
diagnosis  of  umbilical  hernia,  from  which  she  had  been  suffering  for  fifteen  years. 
She  was  very  stout,  and  this  fact  made  an  operation  more  difficult.  In  response  to 
an  inquiry,  the  doctor  sent  this  very  clear  letter: 

“An  operation  for  Mrs.  J  is  not  an  absolute  necessity;  with  a  carefully  made  belt 
or  truss,  strangulation  probably  will  not  occur,  but  if  it  should  occur  wearing  a 
truss  would  increase  the  difficulties  of  an  operation  at  least  50%;  of  course,  in  case 
of  hernia,  whether  umbilical  or  otherwise,  strangulation  is  what  every  surgeon  fears. 
If  the  operation  was  done  for  simple  umbilical  hernia  upon  Mrs.  J,  I  should  say 
the  chances  of  her  getting  well  were  between  65  and  75%;  if  strangulation  took 
place,  her  chances  of  dying  would  be  about  the  above.  She  should  not  be  ill  longer 
than  four  or  five  weeks  and  she  should  be  able  to  be  back  at  work  in  about  eight 
weeks.” 

This  statement  made  it  possible  to  do  two  things.  First,  to  help  Mrs.  J  to  make 
a  deliberate  choice  of  operation  or  no  operation.  She  chose  the  former,  and  says 
now  that  she  has  not  felt  so  well  since  she  was  a  girl  of  sixteen.  Second,  it  enabled 
the  society  to  secure  without  difficulty  the  necessary  relief  and  care  for  the  children. 
The  doctor  underestimated  the  period  of  convalescence,  but  it  was  easy  to  extend 
a  plan  well  started;  it  is  going  to  be  increasingly  difficult  to  launch  one  that  is 
vague  and  formless. 

A  doctor  who  had  been  inclined  to  regard  social  diagnoses  as  a  fad  received  the 
following  letter  from  a  charity  organization  society: 

“Mrs.  K  has  promised  to  go  to  the  dispensary  on  Monday.  Mrs.  K  has  three 
14  209 


SOCIAL  DIAGNOSIS 


children,  aged  nine,  seven,  and  six.  She  had  a  miscarriage  between  the  seven  and 
six  year  old.  Her  husband  was  a  drinking  man  and  very  brutal  to  her.  She  was 
injured  (lacerations,  she  says)  when  her  second  child  was  born.  When  the  youngest 
was  only  four  days  old,  she  was  up  and  moved,  with  a  severe  hemorrhage  as  a  result. 
She  left  her  husband  several  times,  and  finally  two  years  ago  she  sent  him  away  for 
good  and  all.  Since  that  time  she  has  supported  herself  and  the  children  in  various 
ways.  Last  fall  she  took  the  apartment  where  she  now  is,  $16  a  month,  and  worked 

at  the - factory  days  and  at  home  nights  sewing.  For  days  at  a  time,  she  would 

work  until  i  or  2  a.  m.,  then  get  up  and  go  to  the  factory  at  seven.  She  has 
had  trouble  with  varicose  veins,  backache,  and  general  bearing  down  pains.  Her 
head  and  eyes  have  bothered  her  also.  She  has  had  no  regular  physician,  but  was 

told  at  the - Hospital  that  she  had  a  tumor.  We  are  planning  to  pay  her  rent 

for  a  few  months  and  see  how  she  makes  out  on  dressmaking.  Her  flat  is  pleasantly 
situated  and  seems  fairly  good.  The  kitchen  is  in  the  basement,  and  four  rooms 
(one  inside  with  double  doors  into  the  parlor)  are  on  the  first  floor.  They  have  a 
good  bathroom.” 

The  doctor  copied  most  of  these  statements  into  his  medical  record.  It  should 
Mje  added  that  the  social  worker  who  wrote  the  letter  had  had  the  benefit  of  a  short 
period  of  observation  in  a  hospital  social  service  department,  to  which  she  had  gone 
to  study  ways  of  strengthening  the  relation  between  her  own  work  and  that  of  the 
medical  agencies. 

With  the  new  interest  in  public  health,  and  the  developments  of 
public  health  departments  of  the  modern  type,  there  should  be 
many  ways  in  which  the  non-medical  social  agencies  and  these 
departments  can  be  of  service  to  one  another.  The  New  York 
Charity  Organization  Society,  for  example,  reports  service  from  the 
city's  public  Health  Department  in  the  following  ways: 

Department  nurses  give  prenatal  care  to  prospective  mothers,  and  frequently 
persuade  unco-operative  mothers  to  take  their  babies  to  the  Infants’  Milk  Station 
for  examination  and  advice  about  proper  feeding.  Special  examinations  for  workers 
in  restaurants  and  laundries  are  given.  In  homes  where  there  are  contagious 
diseases,  nurses  visit  and  report  needs.  In  the  summer,  when  many  persons,  both 
children  and  adults,  are  sent  for  fresh  air  outings,  the  Health  Department  is  de¬ 
pended  upon  by  the  Charity  Organization  Society  for  many  of  the  required  physical 
examinations.  Photographic  copies  of  records  in  the  Bureau  of  Vital  Statistics  are 
frequently  obtained.  The  Department  effects  forcible  removal  of  tuberculous 
patients  in  infectious  condition  and  forces  unco-operative  patients,  who  have  been 
told  to  return  sputum  for  examination,  to  do  so.  It  maintains  a  special  clinic  for 
venereal  disease,  making  blood  tests  whenever  possible.  The  Board  of  Health  main¬ 
tains  a  special  class  for  children  having  rickets,  a  whooping  cough  clinic  where  serum 
is  administered,  and  dental  clinics  for  school  children.  It  reports  conditions  in 
two-family  houses  which  do  not  come  under  the  supervision  of  the  Tenement  House 
Department.  It  inspects  lodging  houses  and  attends  to  the  segregation  of  tuber- 

210 


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culoils  patients  found  in  them.  One  of  the  greatest  helps  from  the  Health  Depart¬ 
ment  comes  from  the  daily  receipt  by  each  district  office  in  the  Charity  Organiza¬ 
tion  Society  of  the  contagious  disease  bulletin  and  also  the  receipt  of  the  monthly 
bulletin.  The  Health  Department  is  also  helpful  in  giving  information  about 
midwives,  as  from  this  department  midw'ives’  certificates  are  issued.  As  the  tuber¬ 
culosis  clinics  connected  with  the  Health  Department  use  the  Social  Service 
Exchange  of  the  Charity  Organization  Society,  it  is  always  possible  to  know  wrhen 
a  clinic  is  interested  in  a  family  known  to  the  society. 

III.  SOCIAL  RESPONSIBILITY  FOR  EARLY  MEDICAL  DIAGNOSIS 

Medical  authorities  are  agreed  that  any  way  by  which  medical 
diagnosis  could  be  had^ajlier  than  at  present  would  add  materially 
to  the  number  of  cures.  It  is  at  this  point  that  the  non-medical 
social  worker  might  easily  hold  a  strategic  position,  by  cultivating 
a  watchful  eye  for  the  possible  indications  in  family  and  current 
history,  in  personal  appearance  and  in  mental  attitude,  of  those 
physical  and  mental  breakdowns  that  happen  to  have  been  pre¬ 
ceded  by  social  breakdown.  The  non-medical  worker,  if  he  is 
wise,  will  never  attempt  to  make  a  medical  diagnosis,  even  of  the 
most  tentative  kind,  but  he  will  utilize  promptly  every  opportunity 
to  bring  together  the  possible  patient  and  the  expert  medical 
diagnostician.  Early  diagnosis  is  a  very  important  element,  for 
instance,  in  the  cure  of  syphilis,  cancer,  stomach  ulcer,  and  lead¬ 
poisoning,  while  the  prevention  of  infant  blindness  is  a  matter  of 
hours  not  days.  This  is  no  plea  for  a  general  interest  in  health 
campaigns,  which  is  almost  universal  and  often  most  in  evidence 
in  those  very  family  agencies  that  are  neglectful  of  their  oppor¬ 
tunities  to  cure  and  prevent  in  the  individual  case.  The  im¬ 
portant  thing  to  emphasize  here  is  the  daily  exercise  of  our  interest 
by  leaving  no  stone  unturned,  by  making  the  concrete  application 
in  the  detailed  work  of  whatever  kind  for  which  we  stand  respon¬ 
sible  to  the  community. 

Comment  on  one  of  the  case  records  of  a  large  family  agency  reads  as  follows : 
“Visitor  has  certainly  shown  patience  and  sympathy,  and  has  tried  to  align  all 
available  sources  for  relief.  Is  it  not  possible,  however,  that  time  and  money  might 
have  been  saved  if  a  careful  examination  of  the  man  had  been  made  at  once,  in¬ 
stead  of  trying  for  two  months  to  help  him  get  work  w'hich  he  was  physically  unable 
to  do?” 

“  I  remember  with  shame,”  wrrites  a  supervisor  of  case  w’ork,  "a  case  that  I  had 
myself  years  ago  w  here  a  man  wrho  was  thought  to  be  very  lazy  really  had  intestinal 

21  I 


SOCIAL  DIAGNOSIS 


tuberculosis.  In  these  days  a  good  many  case  workers  would  be  quick  to  see  the 
possible  significance  of  symptoms  such  as  his  and  would  arrange  for  a  medical  ex¬ 
amination  promptly,  but  there  are  hundreds  of  others  all  over  the  country  who 
would  not.  We  cannot  emphasize  too  strongly,  it  seems  to  me,  the  importance  of 
securing  medical  examinations  in  all  doubtful  cases,  as  one  of  the  most  important 
principles  of  social  treatment.” 

A  charity  organization  society  secured  surgical  care  for  a  woman  whose  health 
had  been  injured,  according  to  the  society’s  record,  by  running  a  foot  machine  in  a 
factory.  As  soon  as  she  recovered  she  returned  to  the  old  job,  where  she  could  make 
good  wages,  and  her  daughter  was  permitted  to  start  at  the  same  kind  of  work. 

Any  list  of  the  particular  things  relating  to  health  that  are  to  be 
kept  most  in  mind  by  the  non-medical  worker  will  change  yearly 
with  the  rapid  advances  in  medical  knowledge  and  with  the  equally 
rapid  gains  in  the  public  control  of  disease.  Since  the  preparation 
of  this  book  was  begun,  there  has  been  a  marked  change  in  the 
matter  of  workmen’s  compensation  (to  take  an  illustration  that  is 
both  industrial  and  medical),  but  the  responsibilities  and  awkward¬ 
nesses  from  which  these  new  compensation  laws  have  released  the 
social  case  worker  will  enable  him  to  make  his  work  for  individuals 
tell  all  the  better  in  the  allied  field  of  occupational  disease.1  Social 
case  work  will  continue  to  show,  in  its  future  development,  this 
frequent  throwing  off  on  the  one  side  and  annexing  on  the  other. 
To  those  who  may  be  tempted  to  complain  that  too  much  is  ex¬ 
pected  of  the  social  case  worker,  this  is  the  answer.  His  task  con¬ 
tracts  in  a  cheering  way  only  as  he  deliberately  extends  it  in  direc¬ 
tions  that  are  carefully  chosen  and  then  steadily  advanced. 

Owing  to  the  rapid  changes  just  referred  to,  not  even  the  most 
tentative  list  of  health  matters  to  be  kept  in  mind  by  the  social 
diagnostician  can  be  given  here,  but  medical  men  are  beginning  to 
write  for  social  workers,  and  their  statements  should  be  studied 
carefully  at  first  hand.  There  are  excellent  manuals  relating  to 
tuberculosis,  and  recently  we  have  had  a  Layman’s  Handbook  of 
Medicine  prepared  “with  special  reference  to  social  workers”  by 
Dr.  Richard  C.  Cabot,2  in  Which,  among  many  other  things  of  use 
to  us,  he  is  at  pains  to  name  those  diseases  in  which,  owing  to  the 

1  For  illustration  of  the  type  of  case  work  still  needed  in  the  compensation  field, 
however,  see  Chapter  XII,  Employers  and  Other  Work  Sources,  p.  248. 

2  Cabot,  Richard  C.:  A  Layman’s  Handbook  of  Medicine.  With  special  refer¬ 
ence  to  social  workers.  Boston,  Houghton,  Mifflin,  and  Co.,  1916. 

212 


MEDICAL  SOURCES 


importance  of  past  history  in  their  diagnosis,  the  social  worker 
can  be  of  especial  service. 

IV.  METHOD 

It  remains  to  gather  up,  from  notes  made  in  the  course  of  case 
reading,  such  criticisms  and  suggestions  with  regard  to  the  rela¬ 
tions  of  case  workers  to  Medical  Sources  as  will  possibly  help  to 
strengthen  social  diagnosis  on  the  health  side. 

1.  Ask  for  Prognosis.  It  is  not  enough  to  learn  the  name  of  our 
client’s  disease;  even  more  important  are  the  medical  predictions 
as  to  duration  and  probable  outcome — the  physician’s  prognosis. 
We  should  also  be  at  great  pains  to  learn  what  social  treatment  will 
hasten  recovery  and  what  will  help  him  to  avoid  a  recurrence  of 
the  trouble.  In  this  way  the  medical  prognosis  may  become  the 
cornerstone  of  the  social  diagnosis. 

2.  Economize  Resources.  This  lesson  is  needed  at  every  stage 
of  treatment  and  in  the  use  of  every  source  of  information,  but  it 
is  especially  needed  at  this  point  by  workers  in  the  larger  cities, 
for  in  these  Medical  Sources  multiply  very  rapidly,  and  are  some¬ 
times  consulted  wastefully  and  heedlessly  by  the  social  agencies. 
The  very  willingness  of  doctors,  hospitals,  and  dispensaries  to 
serve  is  a  temptation  to  the  social  worker.  They  should  be  con¬ 
sulted  freely,  of  course,  but  should  be  chosen  with  care,  and  for 
better  reasons  than  the  social  worker’s  own  convenience.  A  knowl¬ 
edge  of  the  special  facilities  and  the  limitations  of  medical  agencies 
in  the  worker’s  own  city  is  essential;  and  once  consulted,  these 
should  be  utilized  to  the  full;  should  be  given  the  benefit,  that  is, 
of  whatever  is  known  already,  and  should  be  given  a  free  hand  to 
make  as  complete  a  diagnosis  as  possible.  The  medical  diagnosis 
given  with  encouraging  promptness  is  not  always  the  fullest  or  the 
best,  and  social  workers  should  have  a  special  respect  for  the  physi¬ 
cian  who  hesitates  to  pronounce  judgment  hastily. 

Nowhere,  perhaps,  can  the  scientific  axiom,  “observations  are 
not  to  be  numbered  but  weighed,”  be  more  fittingly  applied  than 
to  the  following  of  medical  dicta.  The  testimony  of  one  physician 
who  knows  is  worth  the  testimony  of  fifty  who  do  not  know.  We 
should  discourage  the  needless  multiplication  of  Medical  Sources, 
therefore,  by  consulting,  at  whatever  cost  of  time  and  trouble  to 

213 


SOCIAL  DIAGNOSIS 


ourselves,  the  very  best  available,  and  then  should  abide  loyally 
by  their  findings. 

In  the  small  community,  even  the  mediocre  specialist  may  not 
be  available  for  mental  and  nervous  examinations,  and  it  may 
devolve  upon  the  social  workers  there — little  fitted  as  they  may 
feel  themselves  for  the  task — to  interest  one  of  the  younger  doctors 
to  make  special  studies  in  this  field.  Many  similar  gaps  remain  to 
be  filled;  there  are  communities  in  the  South  where  no  physician 
has  any  special  knowledge  of  the  treatment  of  pellagra,  and  others, 
both  North  and  South,  where,  even  now,  no  expert  diagnosis  of  a 
case  of  tuberculosis  can  be  had. 

But  in  the  city  of  many  physicians  and  medical  agencies,  how 
shall  we  discover  who  are  the  best  available?  Often  doctors  have 
been  consulted  before  the  social  agency  appears  upon  the  scene,  and 
it  is  necessary  to  turn  to  medical  judgments  already  formed  and 
to  act  upon  these.  Consequently  it  will  sometimes  be  necessary 
to  make  inquiry  about  the  standing  of  the  doctor  in  a  given  case 
among  his  own  fraternity.  The  etiquette  of  the  social  worker’s 
relations  to  a  reputable  but  relatively  incompetent  private  physi¬ 
cian  who  is  in  charge  of  a  difficult  case  requiring  the  best  diagnostic 
skill  has  yet  to  be  worked  out,  but  the  patient’s, interests  demand  a 
not  too  easy  withdrawal  from  a  situation  which  calls  for  both  tact 
and  persistence.  It  is  disheartening  to  read  in  social  records — 
even  in  those  showing  the  deepest  concern  for  the  welfare  of  the 
client  whose  treatment  is  recorded — entries  of  hasty  and  contra¬ 
dictory  opinions  given  by  doctor  after  doctor,  hospital  after  hospi¬ 
tal,  with  blind  faith  in  all  on  the  part  of  the  recorder,  and  with  no 
consciousness  of  failure,  apparently. 

Dr.  Cabot  comments  upon  a  social  record  submitted  to  him  as  follows:  “The 
lack  of  medical  co-operation,  that  is,  lack  (in  the  first  place)  of  ability  and  (in  the 
second  place)  of  frankness  on  the  part  of  the  doctors  concerned  in  the  Boyle-Carey 
family,  has  been  pointed  out  by  various  of  our  social  workers  at  the  Social  Service 
Department,  and  doubtless  by  many  others.  But  the  point  that  I  want  to  make 
about  it  is  this:  It  may  very  well  have  been  impossible  to  secure  adequate  medical 
co-operation,  and  the  workers  on  the  case  may  therefore  have  done  e\  erything  that 
could  have  been  done  to  avert  the  evils  that  came  from  the  lack  of  such  co-opera¬ 
tion.  But  it  is  not  at  all  evident  that  the  workers  were  themselves  aware  that  they 
were  being  checkmated  and  put  on  false  scents  so  frequently  owing  to  the  short¬ 
comings  of  the  doctors.  When  a  person  is  quite  unavoidably  balked  by  such  means, 

214 


MEDICAL  SOURCES 


it  seems  to  me  that  the  records  should  show  some  indication  of  his  rueful  awareness 
thereof,  just  as,  when  a  surgeon  tells  a  patient  that  he  should  be  operated  on  and  the 
patient  refuses,  the  surgeon  is  careful  to  make  it  clear  in  his  record  that  the  subse¬ 
quent  disasters  are  not  his  fault  but  are  due  to  lack  of  proper  co-operation.” 

3.  Seek  First-hand  Information.  This  also  applies  elsewhere, 
but  when  the  statements  are  as  technical  as  medical  diagnoses  and 
prognoses  are  likely  to  be  we  must  guard  this  point  especially.  In 
the  gathering  of  medical  evidence  we  must  avoid  both  oral  and 
second-hand  reporting,  whilst  using  every  possible  device  that  will 
save  the  time  of  the  physician  and  his  busy  hospital  and  dispensary 
assistants.  The  written  diagnosis  is  no  substitute  for  a  personal 
interview  with  the  doctor,  in  which  his  suggestions  as  to  social 
treatment  and  his  fuller  statement  as  to  prognosis  are  procured; 
it  saves  many  misunderstandings,  however,  and  should  not  be 
omitted.  The  secretary  of  a  state  commission  for  the  blind  now 
asks  for  a  written  statement  of  diagnosis,  and,  when  this  is  refused, 
indicates  on  the  record  that  the  diagnosis  came  by  word  of  mouth 
only. 

It  will  not  always  be  possible  to  follow  this  rule,  but  it  is  quite 
possible  to  foreswear  the  gathering  of  medical  information  by  hear¬ 
say.  To  ask  a  patient  what  the  doctor  said  about  his  condition 
and  write  down  the  answer  is  to  quadruple  the  chances  of  error, 
for  the  doctor  may  not  have  told  him  the  whole  truth,  fearing  that 
it  would  unduly  alarm  him;  the  patient  may  not  have  understood 
what  was  said;  he  may  not  remember  accurately;  or  he  may  have 
reasons  of  his  own  for  not  telling  all  that  he  remembers.  Some  one 
or  more  of  these  objections  applies  to  all  evidence  at  second  hand, 
and  its  use  when  the  source  is  accessible  is  a  sign  of  faulty  technique. 

A  worker  in  a  child-placing  agency  heard  a  rumor  that  Mrs.  B,  with  whom  twins 
had  been  placed  to  board,  was  tuberculous.  Accordingly,  fearing  for  the  health  of 
the  agency’s  charges,  she  telephoned  the  charity  organization  society’s  district  sec¬ 
retary,  who  had  known  Mrs.  B.  The  secretary  stated  that  Mrs.  B  had  been  treated 
at  a  certain  hospital  three  years  before  for  tuberculosis  and  that  one  of  her  children 
had  had  tubercular  glands.  Knew  nothing  more  recent  of  physical  conditions,  but 
felt  there  was  absolutely  no  danger  at  this  time.  Agreed  with  child-placing  agent 
that  it  might  not  be  a  good  place  for  a  long  residence.  The  twins  were  removed 
from  the  home  immediately,  though,  save  for  Mrs.  B’s  health,  it  was  a  suitable  one. 

A  case  reader  comments  upon  the  record  of  this  treatment  as  follows '  “I  find 
fault  with  this  action,  first  because  the  hospital  record  was  not  consulted,  and  second, 
for  the  unsound  deduction  that  the  home  might  be  safe  temporarily  but  not  per- 

215 


SOCIAL  DIAGNOSIS 


manently.  If  the  woman  was  in  an  infectious  stage  of  the  disease,  there  was  danger 
to  the  children  during  every  minute  of  their  stay  with  her;  and  if  she  was  not,  they 
could  stay  with  her  indefinitely  provided  she  was  examined  from  time  to  time.” 

4.  A  Medical  Diagnosis  Should  Have  a  Date.  The  illustration 
just  given  serves  to  emphasize  the  further  point  that  physical  and 
mental  conditions  change,  and  that  a  diagnosis  of  six  months  ago 
must  be  brought  up  to  date  before  we  can  safely  make  it  the  basis 
of  social  action. 

5.  Beware  the  Medical  Opinions  of  the  Non-medical.  It  is  only 
natural,  perhaps,  that  non-medical  social  workers  who  see  much  of 
sickness  should  not  only  become  alert  to  its  signs  and  symptoms — 
this  much  they  should  always  be — but  that  they  should  also  begin 
to  pride  themselves  upon  this  alertness,  and  air  their  views  of 
matters  strictly  medical.  “There  is  nothing/'  writes  a  hospital 
social  worker,  in  commenting  upon  a  group  of  case  records  in  which 
this  tendency  appears,  “that  will  more  quickly  antagonize  a  physi¬ 
cian  than  for  the  social  worker  to  make' even  a  suggestion  of  a 
medical  diagnosis.  The  more  medical  training  one  has,  the  more 
cautious  one  grows  about  this."  We  should  be  at  great  pains  to 
give  the  doctor  any  social  facts  that  seem  to  be  significant,  but  we 
should  spare  him,  in  so  doing,  our  medical  guesses.  Otherwise,  we 
are  likely  to  find  in  him,  at  the  very  moment  that  we  most  need  an 
open  mind,  a  closed  one. 

A  medical-social  worker  says  of  her  instructions  to  new  assistants,  “  I  always 
caution  them,  in  asking  a  physician  to  examine  a  patient,  not  to  make  a  diagnosis. 
For  example,  instead  of  taking  a  child  to  the  doctor  and  saying,  ‘I  think  Johnnie 
has  adenoids,’  say,  'Johnnie  sleeps  with  his  mouth  open.  Is  there  any  obstruction 
in  his  nose?”’ 

A  nurse  records  that  a  certain  woman  is  “extremely  thin  and  delicate  looking;” 
a  non-medical  social  worker  describes  the  same  woman  as  “thin  and  consumptive 
looking.”  This  last  term  should  not  be  used  until  after  a  physical  examination. 

A  district  worker  in  a  charity  organization  society  sent  a  girl  to  a  nerve  clinic 
with  this  memorandum :  “  Mary  has  a  delusion  that  she  is  pregnant.”  She  was  found 
to  be  three  and  a  half  months  pregnant  and  a  shocking  condition  of  neighborhood 
immorality  was  unearthed  by  the  discovery. 

6.  Doctor  to  Doctor  Is  More  Frank.  The  Hippocratic  oath1  is 
now  interpreted  more  broadly  than  formerly,  and  doctors  are  often 

1  It  may  interest  social  workers  to  know  the  exact  terms  of  the  Oath  of  Hippoc¬ 
rates.  They  are  as  follows:  “I  swear  by  Apollo  the  physician,  and  Aesculapius 
and  Health  [Hygeia]  and  All-heal  [Panacea],  and  all  the  gods  and  goddesses,  that, 

2l6 


MEDICAL  SOURCES 


willing  to  give  information,  in  confidence,  to  social  workers  whose 
use  of  it  clearly  will  be  not  only  social  but  for  the  best  interests  of 
the  patient.  As  court  procedure  becomes  more  and  more  socialized, 
physicians  will  probably  be  more  willing  than  now  to  place  their 
information  at  the  service  of  judges,  especially  in  cases  involving 
the  welfare  of  children  or  the  protection  of  the  community.  As 
social  work  is  more  skilfully  done,  they  will  treat  social  practi¬ 
tioners  with  a  still  larger  measure  of  confidence  than  at  present. 
Meanwhile,  social  workers  must  recognize  that,  in  difficult  cases, 
doctors  who  do  not  know  them  well  or  understand  their  methods 
of  work  and  are  therefore  unwilling  to  give  them  information  are 
more  likely  to  deal  frankly  with  doctors  who  do  understand  and 
who  are  enough  interested  to  act  as  intermediaries. 

The  social  service  department  of  a  dispensary  sought  the  report  of  a  diagnosis 
made  three  years  before  by  a  large  public  hospital,  explaining  that  it  might  throw 
light  on  the  problem  of  present  treatment.  They  received  promptly  a  diagnosis  of 
"pelvic  disturbance.”  But  the  dispensary  doctor  who  was  treating  the  case,  by 
communicating  directly  with  the  hospital  later,  secured  a  diagnosis  of  "venereal 
infection.” 

The  secretary  of  an  agency  for  the  care  of  girls  reports  that  she  always  prefers 
to  get  a  medical  opinion,  especially  in  perplexing  cases,  through  a  wellknown  physi¬ 
cian  who  is  an  active  member  of  her  directorate.  One  letter  sent  by  the  head  of  an 

according  to  my  ability  and  judgment,  I  will  keep  this  oath  and  this  stipulation — 
to  reckon  him  who  taught  me  this  Art  equally  dear  to  me  as  my  parents,  to  share 
my  substance  with  him,  and  relieve  his  necessities  if  required;  to  look  upon  his 
offspring  in  the  same  footing  as  my  own  brothers,  and  to  teach  them  this  Art,  if 
they  shall  wish  to  learn  it,  without  fee  or  stipulation;  and  that  by  precept,  lecture, 
and  every  other  mode  of  instruction,  I  will  impart  a  knowledge  of  the  Art  to  my 
own  sons,  and  those  of  my  teachers,  and  to  disciples  bound  by  a  stipulation  and  oath 
according  to  the  law  of  medicine,  but  to  none  others.  I  will  follow  that  system  of 
regimen  which,  according  to  my  ability  and  judgment,  I  consider  for  the  benefit  of 
my  patients,  and  abstain  from  whatever  is  deleterious  and  mischievous.  1  will  give  no 
deadly  medicine  to  anyone  if  asked,  nor  suggest  any  such  counsel;  and  in  like  manner 
I  will  not  give  to  a  woman  a  pessary  to  produce  abortion.  With  purity  and  with 
holiness  I  will  pass  my  life  and  practice  my  Art.  I  will  not  cut  persons  laboring 
under  the  stone,  but  will  leave  this  to  be  done  by  men  who  are  practitioners  of  this 
work.  Into  whatever  houses  I  enier,  1  will  go  into  them  for  the  benefit  of  the  sick, 
and  will  abstain  from  every  voluntary  act  of  mischief  and  corruption,  and  further, 
from  the  seduction  of  females  or  males,  of  freedmen  and  slaves.  Whatever,  in  con¬ 
nection  with  my  professional  practice  or  not  in  connection  with  it,  I  see  or  hear, 
in  the  life  of  men,  which  ought  not  to  be  spoken  of  abroad,  I  will  not  divulge,  as 
reckoning  that  all  such  should  be  kept  secret.  While  I  continue  to  keep  this  Oath 
unviolated,  may  it  be  granted  to  me  to  enjoy  life  and  the  practice  of  the  Art,  re¬ 
spected  by  all  men,  in  all  times!  But  should  I  trespass  and  violate  this  Oath,  may 
the  reverse  be  my  lot!” — Genuine  Works  of  Hippocrates,  trans.  from  the  Greek  by 
Francis  Adams,  Vol.  II,  p.  k\.8-8o.  New  York,  Wm.  Wood  and  Co.,  1886. 

217 


SOCIAL  DIAGNOSIS 


institution  for  the  feeble-minded  in  answer  to  the  inquiry  of  this  physician  is  as 

follows:  “It  appears  that - is  about  two  years  behind  in  school  work,  perhaps 

a  little  more,  but  her  defect  seems  quantitative  rather  than  qualitative,  and  I  do 
not  believe  that  she  is  defective  enough  to  warrant  her  commitment  at  this  time. 
I  told  the  young  lady  who  brought  her  that  I  thought  the  problem  would  have  to 
be  worked  out  further  before  anything  could  be  done.  Her  responses  to  the  labora¬ 
tory  tests  were  not  convincing,  but  she  has  the  natural  feminine  subtlety  and 
reticence,  and  I  do  not  believe  that  a  single  examination  would  begin  to  map  out 
the  entire  field.  Should  her  dishonest  habits  continue  [the  girl  had  been  stealing 
money]  she  might  be  committed  to  the  reform  school,  and  there  they  would  have 
the  opportunity  and  are  properly  equipped  to  make  a  thorough  study  of  the  prob¬ 
lem." 

7.  Careful  Reporting  Wears  Away  Prejudice.  An  unco-opera¬ 

tive  attitude  on  the  part  of  physicians,  where  the  social  worker 
needs  their  help  in  securing  social  action  (whether  in  individual 
cases  or  in  other  ways),  can  sometimes  be  accounted  for  by  the 
inability  of  the  non-medical  social  worker  to  make  his  daily  con¬ 
tacts  with  Medical  Sources  as  helpful  as  they  should  be.  Written 
summaries  of  the  social  side  of  any  case  reported  for  diagnosis  or 
treatment  are  aids  to  this,  provided  they  are  accurate,  clear,  and 
without  irrelevant  detail.  » 

Dr.  Adolf  Meyer,  in  commenting  upon  the  same  record  that  was  submitted  to 
Dr.  Cabot,1  points  out  the  shortcomings  of  certain  medical  reports  in  the  case  and 
adds:  “They  probably  also  never  had  a  written  summary  of  the  type  of  the  one 
sent  Mrs.  Scott  [superintendent  of  the  girls’  reformatory].  .  .  .  Now  a  consulting 
alienist  such  as  was  to  be  appealed  to  would  really  have  been  unjustified  in  making  a 
far-reaching  estimate  without  such  documents  or  copies  of  documents." 

A  critic  of  this  criticism  submits  that,  while  it  is  well  to  present  a  written  social 
summary,  the  doctor  does  not  always  read  it.  A  better  way,  according  to  this  second 
critic,  would  be  to  make  a  report  orally  to  the  doctor,  to  interest  him  in  the  material 
that  the  social  worker  has  to  give,  and  then  hand  him  the  written  summary  before 
leaving.  At  the  time,  it  might  mean  little  to  him,  but  two  months  later,  when  he 
knew  his  patient  better,  some  part  of  it  might  mean  a  great  deal. 

When  a  Medical  Source  has  been  helpful  in  a  given  case,  it  would 
be  well  worth  while  to  report  briefly  to  that  source  later  in  just 
what  manner  the  help  had  furthered  social  treatment,  thus 
strengthening  the  relations  of  the  two  kinds  of  work  at  their  point 
of  intersection. 

8.  Miscellaneous  Suggestions.  The  following  suggestions  as  to 
the  detailed  use  of  Medical  Sources  need  no  illustration: 


1  See  p.  214. 
2l8 


MEDICAL  SOURCES 


To  establish  the  identity  of  a  record  or  of  a  patient  in  a  large 
hospital  the  name  or  number  of  the  ward,  and,  in  large  dispensaries, 
the  number  of  the  patient’s  dispensary  card,  will  be  found  useful. 

/  The  lodge  doctor  can  frequently  give  some  medical  report  and 
other  information  about  the  men  of  the  family.  This  is  especially 
true  in  foreign  families,  where  it  often  happens  that  no  other  physi¬ 
cian  has  been  consulted. 

Medical  records  sometimes  contain  non-medical  information  of 
value.  New  York  hospitals,  for  instance,  record  the  names  and 
addresses  of  the  two  nearest  relatives  or  friends  of  the  patient. 
A  tuberculosis  sanatorium,  by  recording  the  name  of  the  person 
responsible  for  the  payment  of  board,  helped  a  non-medical  agency 
to  discover  several  years  later  a  co-operative  relative.  One  hospital 
record  brought  to  light  the  approximate  amount  and  the  where¬ 
abouts  of  money  in  bank. 

The  physician  who  has  treated  some  family  regularly  for  years  is 
able  to  throw  light  on  other  home  matters  than  the  health  of  its 
members.  At  times  of  sickness  and  death  relatives  appear  who 
have  not  been  heard  of  before,  and  the  family  doctor  is  in  a  goDd 
position  to  estimate  the  depth  of  their  interest,  as  well  as  the  close¬ 
ness  of  the  bond  within  the  immediate  family  group. 

SUMMARY  OF  THIS  CHAPTER 

1.  So  marked  is  the  emphasis  now  put  upon  data  about  health  and  disease  in 
nearly  all  forms  of  social  case  work,  that  any  failures  of  Medical  Sources  as  witnesses 
stand  out  in  bold  relief.  These  failures  fall  under  the  three  heads  of  (i)  non-social 
attitude;  (2)  conflicting  diagnoses  and  prognoses;  (3)  faulty  medical  records. 

2.  Parallel  failures  should  be  noted  in  the  witness  of  social  work  sources  to  the 
medical  profession.  Conflicting  diagnoses  and  prognoses  are  even  more  common  in 
social  work  than  in  medicine. 

3.  The  two  types  of  data — social  and  medical — are  complementary.  It  follows 
that  social  workers  might  hold  a  strategic  position,  were  they  better  equipped  to 
recognize  and  report  upon  the  early  signs  of  impending  physical  or  mental  break¬ 
down.  Earlier  reporting  of  these  signs  would  add  materially  to  the  number  of  cures.- 
It  is  impossible  to  overstate  the  importance  cf  cultivating  a  habit  of  awareness  at 
this  point,  of  being  alertly  watchful  for  the  more  obscure  signs  of  breakdown. 

4.  In  all  relations  with  doctors,  hospitals,  etc.,  we  should 

(1)  Ask  for  prognosis  as  well  as  diagnosis,  for  the  probable  duration  and  outcome 
of  the  disease,  and  for  ways  of  helping  to  hasten  recovery  and  avoid  recurrence 

219 


SOCIAL  DIAGNOSIS 


f.  •  • 

f 

1  •.  * 

(2)  Economize  medical  resources,  by  selecting  the  best  sources  and  using  them 
to  the  full 

(3)  Seek  first-hand  information,  and  not  depend  upon  hearsay  statements  of 
“what  the  doctor  said” 

(4)  Note  the  date  of  a  medical  diagnosis  before  making  it  the  basis  of  social 
action 

(5)  Beware  the  medical  opinions  of  the  non-medical 

(6)  Seek  the  mediation  of  a  physician  in  securing  important  medical  information 
not  otherwise  procurable 

(7)  Report  with  special  care  the  social  side  of  medical  cases. 


/ 

h 


220 


. 


CHAPTER  XI 


SCHOOLS  AS  SOURCES 

HERE  are  sources  of  information  that  seem  to  have  been  im¬ 
perfectly  used  as  yet  by  social  workers.  It  is  true  that 
many  of  the  agencies  studied  consult  school  officials  (they 
were  consulted  687  times  in  the  2,800  cases  already  referred  to), 
but  an  examination  of  the  individual  items  seems  to  show  that 
both  family  agencies  and  those  for  the  care  of  dependent  children 
do  not  confer  with  educators  often  enough.1  The  children's  agencies 
have  many  charges  that  are  under  school  age,  but,  even  after 
allowing  for  this,  consultations  with  School  Sources  are  too  infre¬ 
quent,  if  the  statistics  at  hand  are  at  all  representative  of  the 
usual  practice. 

A  formal  school  report  giving  a  child’s  grade,  and  his  marks 
for  scholarship,  attendance,  and  deportment,  leaves  many  of  the 
most  important  questions  about  him  unanswered,  as  the  following 
comments,  written  by  one  who  was  making  a  survey  of  the  case 
work  of  a  certain  charity  organization  society,  indicate: 

A  driver,  supposed  to  be  intemperate,  a  wife,  and  four  children,  thirteen  to  three. 
Known  to  the  society  since  December  24,  1908.  An  unsatisfactory  record  cul¬ 
minating  in  a  “sob”  story  in  the  newspapers.  I  notice  that  what  to  me  is  the  most 
important  source  of  information — more  important  than  landlords  and  former  resi¬ 
dences — was  not  consulted  at  all,  namely,  the  school  in  which  two  or  three  of  the 
children  must  have  been  entered.  The  physical  condition  of  the  children,  any  evi¬ 
dences  of  the  moral  background  of  their  home  which  came  out  at  the  school,  indi¬ 
cations  of  their  mental  condition,  whether  they  were  laggards  or  not,  whether  they 
came  to  school  looking  well  cared  for — all  of  this  would  be  extremely  valuable  in 
further  treatment.  In  other  words,  is  there  a  leverage  upon  this  family  through 
their  love  of  the  children  revealed  in  proper  care,  or  will  more  coercive  remedies  be 
necessary?  For  the  children’s  sake,  this  family  cannot  be  dropped. 

1  This  impression  has  been  strengthened  recently  by  the  findings  of  the  Spring- 
field  (111.)  Survey.  The  failure  of  the  Associated  Charities  of  Springfield  to  consult 
School  Sources  about  the  families  in  which  it  was  interested  had  kept  it  ignorant 
of  one  of  the  most  serious  evils  permitted  by  the  city  administration;  namely, 
irregular  school  attendance.  See  Francis  H.  McLean  on  The  Charities  of  Spring- 
field,  pp.  89-93. 


I 

i 

1 


221 


SOCIAL  DIAGNOSIS 


An  Italian  couple  with  three  children,  eleven,  eight,  and  six.  The  man  has  open 
sores,  but  earns  $4.00  a  week;  the  wife  is  supposed  at  first  to  be  tuberculous  but 
afterwards  this  is  found  to  be  incorrect.  It  is  determined  that  there  is  no  hope  of 
this  family  itself,  and  an  attempt  is  made  to  have  the  S.  P.  C.  C.  take  the  children 
away  by  court  proceedings.  They  are  now  with  their  parents  on  parole  to  March  8. 
Here  again  I  notice  that  one  of  the  most  important  sources,  the  public  school,  was 
not  consulted  regarding  the  condition  of  the  children,  though  what  would  have  been 
gathered  there  would  have  been  of  the  utmost  importance  either  in  strengthening 
the  appeal  to  have  the  children  taken  away,  or  in  indicating,  as  so  often  happens 
in  Italian  cases,  that  there  are  unrevealed  sources  of  income  and  of  strength  (through 
family  connections)  which  could  be  utilized.  This  might  have  required  specially 
arranged  observations  on  the  part  of  the  school  teachers. 


Societies  for  the  protection  of  children  from  cruelty  seem  to 
consult  teachers  habitually — some  of  them  to  the  exclusion  of  other 
equally  valuable  sources,  and  nothing  that  is  said  in  this  chapter 
as  to  the  great  value  of  school  evidence  must  be  interpreted  as  an 
argument  for  the  exclusion  of  other  points  of  view.  The  “  neglect 
case”  is  one  that  especially  attracts  the  teacher’s  attention.  The 
child  comes  to  school  ill  clad,  unclean,  suffering  often  from  pedicu¬ 
losis,  and  sometimes  sick.  The  medical  inspector’s  reports  have 
not  been  heeded  at  home,  the  parents  have  been  sent  for  and  inter¬ 
viewed  with  no  effect.  Naturally,  in  such  cases,  teachers  have 
direct  evidence  to  give  to  agents  for  protection  from  cruelty  and 
to  probation  officers.  They  are  able  to  see  direct  benefit,  more¬ 
over,  from  their  co-operation  with  both,  for  the  very  terms  of  pro¬ 
bation  require,  in  the  case  of  school  children  who  have  been  de¬ 
linquents,  a  satisfactory  report  to  the  court  by  the  probation  officer 
of  school  attendance,  conduct,  and  scholarship. 

These  are  the  marked  social  failures,  however — failures  in  which 
the  family  neglects  the  most  elementary  duties  to  the  child,  or 
in  which,  through  lacks  within  the  home  or  outside,  the  child  and 
society  are  brought  into  apparent  conflict  and  there  is  obvious 
need  of  readjustment.  At  many  earlier  stages,  before  such  neg¬ 
lect  develops,  school  evidence  could  come  in  with  even  greater 
effect  than  it  can  later  to  prevent  these  sharp  collisions.  The 
early  symptoms  of  social  breakdown  are  quite  as  important  as  the 
early  symptoms  of  bodily  disease,  and  the  teacher  is  in  an  admirable 
position  to  observe  these  social  symptoms — in  so  admirable  a  posi¬ 
tion,  indeed,  that  many  social  activities  may  be  centered  in  the 

222 


SCHOOLS  AS  SOURCES 


schools  temporarily,  some  of  them  to  be  very  soon  removed  again. 
For  in  the  long  run  teachers  themselves  will  see  the  importance  of 
concentration  upon  their  own  task:  they  will  realize  that  they  can 
give  better  social  evidence  and  make  a  better  contribution  to  social 
welfare  when  their  time  is  freed  from  a  variety  of  social  work  items 
— such  as  home  visiting,  vocational  guidance,  health  matters, 
etc. — for  teaching  under  conditions  that  make  a  very  high  grade  of 
individualized  instruction  possible.  A  public  school  system  in  a 
large  city  lists  seventeen  points  upon  which  its  teachers  are  marked 
for  renewal  of  license,  but  unfortunately  the  ability  to  individu¬ 
alize  their  pupils  is  not  one  of  the  seventeen.  Our  case  reading 
shows  that  many  teachers  are  already  eager  to  win  the  co-opera¬ 
tion  of  those  who  know  the  home  background  intimately,  because 
the  home  background  will  help  them  to  do  this  very  thing,  to 
adapt  their  teaching  to  the  needs  and  capabilities  of  each  child. 

I.  THE  SOCIAL  EVIDENCE  OF  TEACHERS 

What  are  some  of  the  things  that  teachers  who  individualize 
their  pupils  can  tell  the  social  worker?  What  light  that  cannot 
be  had  elsewhere  are  they  able  to  throw  on  social  situations?  And 
what  can  the  social  worker  do  with  this  information  that  will 
bring  direct  benefits  into  the  school  room?  These  questions  are 
considered  under  the  subheads  of  grade,  scholarship,  attendance, 
behavior,  physical  condition,  mental  condition,  home  care,  and 
results  of  social  treatment. 

1.  Grade.  Taking  the  simplest  thing  first,  grade  is  a  matter  of 
record,  and  the  mere  fact  is  one  about  which  the  individual  teacher 
need  not  be  troubled.1  Some  agencies  seek  records  of  grade  and 
the  other  school  marks  as  a  matter  of  routine.  This  is  good  as 

1  Cumulative,  individual  record  cards  giving  the  school  history  of  each  child 
have  been  introduced  into  most  of  the  progressive  city  school  systems.  The  form 
used  is  one  agreed  upon  by  the  United  States  Bureau  of  Education  and  the  National 
Education  Association  in  1911.  These  records  pass  from  teacher  to  teacher  and 
from  school  to  school  as  the  pupil  is  promoted  or  transferred.  They  give  for  each 
child  information  under  the  following  headings:  Last  name,  first  name  and  initial, 
place  of  birth,  date  of  birth,  vaccination,  name  of  parent  or  guardian,  occupation 
of  parent  or  guardian,  residence,  school,  date  of  admission,  date  of  discharge,  age, 
grade,  room,  regularity  of  attendance,  health,  conduct,  scholarship.  These  records 
may  be  found  in  the  individual  class  room,  in  the  principal’s  office,  or  in  the  super¬ 
intendent’s  office;  hence  careful  inquiry  should  be  made  before  assuming  that  they 
are  not  kept. 


223 


SOCIAL  DIAGNOSIS 


far  as  it  goes,  but  the  routine  entry  of  a  child’s  grade  upon  a  social 
record  has  little  significance  except  in  relation  to  other  facts,  such 
as  the  age  of  the  child  when  first  entered  at  school,  the  family  re¬ 
movals  from  city  to  city,  and  from  one  city  neighborhood  to  an¬ 
other,  school  absences  due  to  sickness  and  to  other  causes  if  any, 
the  child’s  knowledge  of  the  English  language,  etc.  The  general 
school  standards  of  the  community  must  also  be  known,  such  as 
the  usual  age  for  each  grade  and  the  extent  to  which  school  over¬ 
crowding,  seat  overcrowding,  and  part-time  classes  enter  into  and 
modify  the  particular  condition  under  review.  If  these  facts  are 
all  at  hand,  they  can  be  co-ordinated  and  inferences  of  a  certain 
value  can  be  drawn  from  them  without  a  personal  interview  with 
each  teacher. 

It  must  not  be  forgotten  that  a  child  gets  much  more  out  of 
school  if  he  is  in  a  grade  with  children  of  his  own  age.  The  waste 
of  social  efficiency  that  comes  through  failure  to  win  promotions 
at  the  normal  rate  makes  this  question  of  school  grade  an  important 
one  in  itself;  as  a  symptom  it  is  even  more  important,  related  as 
it  is  to  all  the  items  that  here  follow.  It  will  be  seen  that  most 
of  these  need  the  personal  interpretation  of  the  teacher  or  principal. 

2.  Scholarship.  A  general  scholarship  mark  is  not  so  significant 
as  are  marks  showing  relative  standing  in  different  studies,  and 
these  again  are  not  so  significant  as  the  teacher’s  own  observations 
of  the  child’s  mental  reactions.  Often  these  observations  come  out 
when  the  social  worker  asks  questions  based  upon  his  own  inexpert 
inferences  from  school  marks. 

A  charity  organization  society  was  helped  by  three  school  principals  in  its  treat¬ 
ment  of  a  widow  with  three  children,  who  was  in  receipt  of  a  private  allowance  from 
the  society.  First  a  grammar  school  principal  induced  the  society  to  undertake  the 
training  of  the  girl  of  eleven  for  the  profession  of  teaching.  She  had  unusual  ability. 
Then  the  older  boy  in  the  family  was  found  to  be  a  number  two  student  at  the  high 
school.  He  was  taken  to  the  principal  of  a  mechanical  high  school  for  advice,  and, 
after  a  long  interview  between  the  boy  and  the  principal,  it  was  decided  that  the 
boy  would  probably  do  better  in  commercial  studies.  He  was  taken  also  to  the 
principal  of  the  commercial  high  school,  who  confirmed  this  judgment.  After  a 
year’s  trial,  it  seems  to  have  been  a  wise  one,  as  the  boy  has  done  much  better  than 
in  the  academic  course. 

In  more  progressive  communities,  scholarship,  grade,  and  at¬ 
tendance  tests  are  combined  with  physical  tests  to  replace  age  re- 

224 


SCHOOLS  AS  SOURCES 


quirements  in  determining  the  time  at  which  children  shall  be  per¬ 
mitted  to  have  their  working  papers.  But  there  are  other  and  better 
reasons  for  keeping  informed  about  these  school  matters.  Social 
workers  can  be  too  eager  to  get  children  ready  for  the  minimum  work 
requirement;  they  cannot  be  too  eager  to  get  them  ready  for  life. 

3.  Attendance.  Non-enrollment  is  not  the  chief  evil,  even  in 
communities  that  have  no  compulsory  attendance  laws;  irregular 
attendance  is  a  still  greater  evil,  and  one  which  most  cities  are 
dealing  with  through  special  departments  and  special  officers.  In 
the  2,800  cases  reviewed,  attendance  officers  had  been  consulted 
77  times  as  compared  with  485  consultations  with  teachers  and 
school  principals.  Educators  feel  that  the  attendance  officer’s 
task  is  in  need  of  reorganization.  As  now  interpreted  his  is  un¬ 
doubtedly  a  narrow  specialty,  and  his  social  evidence  is  crippled 
by  this  fact.1  He  can  testify  to  the  condition  of  the  home  as  he  saw 
it  at  the  time  of  his  visits,  and,  if  the  visits  are  well  timed,  this 
yields  something,  but  not  very  much.  No  such  revealing  observa¬ 
tions  by  attendance  officers  have  been  discovered  in  the  course  of 
our  case  reading  as  the  following  from  a  school  principal: 

Visit  made  to  school  in  the  interest  of  an  Italian  widow’s  family;  five  children, 
three  in  one  school  as  follows:  Maria  fifteen,  John  eleven,  Angelo  eight.  Maria’s 
report  for  September,  “  Deportment  excellent,  scholarship  fair,  attendance  two  half 
days  excused.”  Principal  says  she  is  in  high  seventh  grade  and  will  pass  into  eighth 
in  February.  He  looked  up  her  grades  for  last  year  and  said  she  must  have  done 
very  well,  as  the  teacher  she  had  was  a  very  strict  marker.  Regards  her  as  a  wonder¬ 
ful  girl,  very  straightforward  and  competent. 

John,  now  at  the  truant  school,  was  a  chronic  truant,  a  cigarette  fiend,  and 
generally  incorrigible.  The  former  principal,  whom  this  one  succeeded  nine  months 
ago,  used  to  let  the  boy  stay  away  from  school  without  hindrance,  as  he  was  so 
great  a  problem  when  there.  The  present  principal  found  that  John  was  roaming 
the  streets  and  made  every  effort  to  keep  him  in  school;  would  send  for  Maria  and 
she  and  her  mother  would  scour  the  streets  until  they  found  the  boy.  Was  a  boy 
of  nomadic  tendencies  that  must  be  reckoned  with,  so  gave  him  permission  to  leave 
the  school  whenever  he  came  to  the  office  and  asked  for  it.  Later  gave  him  the 
task  of  watching  and  entertaining  the  kindergarten  children  between  11.15  when 
they  were  dismissed  and  12  o’clock  when  older  brothers  and  sisters  called  for  them. 
He  was  remarkably  successful  in  this,  but  it  did  not  solve  the  cigarette  smoking  or 
the  truancy  entirely. 

1  From  one  city,  however,  comes  the  testimony  of  a  competent  social  case  worker 
that  the  only  effective  case  work  that  she  could  find  there  was  being  done  by  the 
attendance  officers. 

15 


225 


SOCIAL  DIAGNOSIS 


The  principal  found  that  an  eighth  grade  boy  in  another  school  was  leading  John 
and  a  companion  in  all  their  misdoings.  They  used  to  go  to  the  home  of  one  of  the 
boys  and  "cut  high  capers."  .  .  .  Boy  was  kind  and  lovable  at  times  but  had 

a  bad  temper  and  was  vindictive  when  crossed.  A  physical  examination  had 
brought  out  the  fact  that  he  had  rheumatism  and  heart  trouble  and  the  teachers 
were  afraid  to  discipline  him.  This,  with  a  number  of  other  factors,  contributed 
to  the  thorough  spoiling  of  the  boy.  At  one  time  a  charitable  lady  had  taken  a 
great  interest  in  him — gave  him  money  to  buy  candy  as  an  antidote  for  the  cigarettes, 
perhaps,  but  dropped  him  later  more  spoiled  than  ever.  Finally  principal  had  sent 
him  up  for  truancy  in  order  that  he  might  have  to  do  without  cigarettes  for  a  while. 
He  was  in  the  third  grade  at  the  time.  [Report  on  one  other  boy  in  the  family 
follows.] 

In  families  that  are  in  receipt  of  regular  allowances  from  an 
agency,  public  or  private,  it  is  possible  for  the  agency  to  regulate 
school  attendance  by  arranging  with  the  children's  teachers  to 
furnish  a  written  school  report  each  week,  and  then  making  relief 
conditional  upon  a  good  attendance  record. 

4.  Behavior.  This  should  be  taken  to  cover  a  good  many 
personal  characteristics  not  usually  covered  by  the  more  formal 
word  “deportment"  or  “conduct."  If  a  girl  seems  to  have  the 
idea  that  the  world  is  against  her  and  shows  it  by  repelling  friendly 
advances  from  her  classmates,  that  is  a  more  important  fact  than 
that  her  deportment  is  “poor."  We  must  learn  to  seek  for  the 
description  of  the  child’s  acts,  motives,  desires,  tendencies,  in¬ 
stead  of  for  the  reactions  of  the  teacher  to  her  more  or  less  un¬ 
pleasant  experiences.  Sometimes  it  is  necessary,  as  tactfully  as 
possible,  to  push  beyond  the  initial  school  statement. 

A  probation  officer  reports  a  boy  of  eleven  who  the  teacher  thought  was  feeble¬ 
minded  but  the  doctors  said  was  not.  His  teacher  was  urged  to  try  a  class  in  raffia 
work  and  so  give  the  boy  a  chance  with  his  hands.  General  statements  as  to  this 
work  and  as  to  his  mental  work  were  analyzed,  by  close  questioning,  into  the  fol¬ 
lowing:  In  the  first  hour  he  did  fairly  well;  second  hour,  work  less  satisfactory; 
third  hour,  nothing.  By  probing  still  further,  it  was  found  that  the  boy  came  with¬ 
out  any  breakfast.  This  was  not  due  to  poverty  but  to  carelessness  and  to  the  boy’s 
lack  of  appetite.  Both  parents  were  seen  about  it,  and,  by  special  permission,  the 
boy  was  sent  home  at  recess  for  extra  feeding. 

Her  stepmother  had  decided  to  put  a  girl  of  thirteen  away,  but  the  parish  priest 
urged  the  judge  not  to  commit  the  girl  and  appealed  to  the  child’s  school  principal 
to  justify  his  judgment  by  doing  her  best  to  make  a  good  girl  of  one  who  screamed 
wildly  on  the  streets  until  the  neighbors  complained,  stayed  out  to  play  with  rough 
boys  after  ten  at  night,  refused  to  do  any  work  at  home,  etc.  The  girl  was  referred 
every  day  for  two  weeks  to  the  principal’s  office  for  bad  behavior  in  the  class  room, 

226 


SCHOOLS  AS  SOURCES 


and  was  then  referred  to  a  home  and 'school  visitor,  who  had  quiet  talks  with  her  in 
which  the  before-mentioned  acts  were  discussed  in  detail  The  visitor  decided  that 
she  needed  the  advice  of  a  neurologist.  Consultation  with  one  brought  a  diag¬ 
nosis  of  the  early  stages  of  St.  Vitus’s  dance.  Treatment,  a  course  of  dieting,  salt 
baths,  long  hours  of  rest,  temporary  withdrawal  from  school,  country  outing  for 
two  months,  two  more  months  with  an  aunt  in  the  suburbs.  Result,  return  to 
school  in  good  mental  and  physical  condition. 

5.  Physical  Condition.  A  teacher  who  has  had  a  few  such  ex¬ 
periences  as  the  foregoing  is  tempted  to  suspect  “the  early  stages 
of  St.  Vitus’s  dance”  in  all  her  more  troublesome  pupils.  Social 
workers  make  equally  hasty  generalizations.  Among  the  earliest 
of  the  physical  disabilities  to  win  a  commanding  position  as  an 
explanation  of  trouble  in  the  school  room  were  positional  defects; 
but  adenoids,  eye  strain,  and  now  (among  the  mental  difficulties) 
feeble-mindedness  either  have  been  or  are  very  popular.  Needless 
to  say,  the  discovery  of  all  these  conditions  is  of  the  gravest  im¬ 
portance  in  the  right  place — in  the  place,  that  is,  where  they  really 
exist.  The  teacher  must  not  play  physician,  but,  like  the  social 
worker,  he  can  help  tojget  his  pupils  to  the  right  specialist  at  the 
earliest  possible  moment,  suspending  judgment  meanwhile,  and 
keeping  watch  for  the  evidence  that  disproves  his  explanation. 
Medical  inspection  in  the  schools  is  neither  thorough  enough  nor 
frequent  enough  at  present  to  relieve  the  teachers  entirely  of  this 
duty.  Certain  individual  variations  in  children  that  are  due  to 
physical  or  nervous  disturbance  are  evident,  moreover,  only  to 
one  who  has  them  under  observation  continuously. 

From  a  hospital  social  service  department  comes  this  memorandum:  Diagnosis 
of  a  girl  was  epilepsy,  and  our  department  was  asked  to  follow  this  up  by  inquiries 
at  the  home  and  the  school.  Teacher  said,  “Child  has  far  fewer  attacks  when  she 
is  not  noticed.”  This  gave  a  clue.  A  period  of  observation  in  a  hospital  was  ar¬ 
ranged  for,  and  the  suggestion  that  the  child  had  hysteria  was  confirmed. 

6.  Mental  Condition.  The  illustration  just  given  might  very 
well  have  been  placed  under  this  heading  instead  of  under  “physi¬ 
cal  condition,”  but  it  has  been  allowed  to  stand  where  it  is  because 
observations  of  physical  habits  and  temperamental  dispositions, 
of  aptitudes  for  one  or  another  study,  of  variations  in  response  to 
stimuli  at  different  times  of  day,  days  of  the  month,  seasons  of  the 
year — all  these  things  have  a  direct  relation  to  both  physical  and 
mental  states. 


227 


SOCIAL  DIAGNOSIS 


A  case  worker,  in  commenting  upon  the  record  of  a  difficult  girl  who  was  later 
committed  to  an  institution  for  the  feeble-minded,  calls  attention  to  the  fact  that 
the  girl  received  low  marks  in  arithmetic,  grammar,  domestic  work,  and  sewing, 
all  requiring  reasoning  and  action  based  upon  reasoning,  while  in  memory  studies — 
geography,  history,  spelling — in  deportment,  which  may  be  largely  imitation,  and 
in  the  mere  mechanical  keeping  of  things  in  place  in  her  room,  she  had  much  higher 
marks.  Until  the  psychologists  can  speak  with  more  assurance,  however,  it  would 
seem  unwise  to  put  great  confidence  in  comparative  marks  in  different  subjects. 
The  teacher’s  own  observations  concerning  the  child’s  abilities  are  more  trust¬ 
worthy. 

Commenting  on  another  history  of  a  girl  also  committed  later,  another  case 
worker  writes,  “The  visits  to  the  teachers  brought  nothing  but  generalities.  Not  an 
illustration  is  given,  merely  obscure  terms,  such  as  ‘on  the  whole  consider  her  bad,’ 
‘of  average  ability,’  etc.” 

Writing  about  the  questionnaire  on  a  Child  Possibly  Feeble¬ 
minded  in  Part  III,  a  distinguished  psychiatrist  says,  “In  reality, 
the  questionnaire  of  a  Feeble-minded  Child  is  a  list  of  all  the  ques¬ 
tions  that  may  be  asked  about  any  child”;  and  if  the  questionnaire 
about  which  this  comment  was  made  had  been  intended  as  a  blank 
to  be  filled  out,  instead  of  as  a  series  of  suggestions  to  be  examined 
carefully  by  the  social  worker,  the  criticism  would  have  been  a 
damaging  one. 

At  the  time  that  the  study  of  case  records  for  this  book  was  pro¬ 
ceeding,  agitation  for  the  segregation  and  humane  care  of  the 
feeble-minded  child  was  just  beginning  to  make  new  headway 
under  the  impetus  given  to  it  by  recent  eugenic  studies,  so  that  a 
good  many  illustrations  are  at  hand  of  school  initiative  in  trying 
to  secure  transfers  to  institutions  for  the  feeble-minded.  The 
records  studied  show  that  some  of  these  children  were  feeble¬ 
minded  and  that  some  were  not. 

A  probation  officer  was  asked  by  a  teacher  to  interest  herself  in  a  boy  who  was 
“certainly  feeble-minded,  for  nothing  could  be  done  with  him  in  the  school  room.” 
Under  probationary  treatment,  however,  and  with  the  heartiest  co-operation  of 
the  teacher,  the  boy  began  to  bring  better  and  better  reports.  For  instance,  on 
a  certain  day  the  boy  appeared  at  the  probation  office  with  a  report  of  which  he 
was  particularly  proud,  to  find  only  a  substitute  in  charge.  His  disappointment  was 
so  obvious  that  his  teacher  was  at  great  pains  to  communicate  with  the  probation 
officer  promptly,  and  to  make  the  boy  feel  that  both  teacher  and  officer  regarded 
that  report  as  a  matter  of  real  moment. 

In  a  case  submitted  for  study  by  a  child-saving  agency  the  agency,  after  a  period 
of  observation  in  a  hospital,  had  placed  a  girl  of  seven  at  board  in  one  of  the  smaller 

228 


SCHOOLS  AS  SOURCES 


towns  of  the  state.  The  diagnosis  was  "a  mild  form  of  chorea.  With  proper 
management  in  a  home  outside  will  improve  rapidly.”  Four  months  later,  the 
child  was  reported  as  taking  great  interest  in  exciting  the  other  children  in  school. 
Next  month,  the  superintendent  of  schools,  with  the  endorsement  of  the  school 
physician,  writes  to  the  agency  that  child  is  mentally  defective.  Again,  three 
months  later,  he  writes  more  urgently,  and  a  physician  of  the  state  institution  for 
the  feeble-minded  is  consulted.  The  girl  is  taken  there  under  observation.  First 
report,  “  Brighter  in  many  ways  than  most  of  the  children  at  the  school.  She  seems 
to  have  no  moral  sense.”  Report  after  seven  weeks,  ”1  am  convinced  that  the 
little  girl  is  deficient  mentally.” 

The  choice  between  leaving  a  child  who  can  be  described  as 
having  “no  moral  sense”  in  contact  with  normal  school  children 
for  months,  and  branding  her  as  feeble-minded  when  there  is 
reasonable  doubt,  is  not  an  easy  one  to  make.  In  cases  such  as  the 
one  just  cited,  of  a  child  bright  in  some  ways  but  abnormal,  the 
highest  available  authority  should  be  consulted  promptly.  The 
school  superintendent  urged  that  the  little  girl  had  “the  attitude 
and  the  motions  of  many  of  the  school  for  feeble-minded  children,” 
but  was  not  more  specific  in  his  statements.  He  was  correct  in  his 
inference,  however,  and  school  evidence  will  have  to  play  an  im¬ 
portant  part  in  the  discovery  and  segregation  of  defectives. 

7.  Home  Care.  It  has  already  been  suggested  that  teachers 
are  excellent  witnesses  as  to  the  signs  of  home  neglect.1  They 
are  equally  able  to  give  testimony  as  to  good  home  nurture.  This 
is  partly  due  to  the  fact  that  they  have  a  basis  of  comparison  in 
the  procession  of  classes  coming  under  their  care.  It  is  also  true 
that,  as  regards  home  matters,  teachers  belong  in  the  group  of 
“supplementary  clues”  mentioned  on  page  174;  they  are  not  in¬ 
cluded  usually  in  the  list  of  neighbors  and  personal  references  put 
forward  in  the  first  interview  by  a  new  client  as  prepared  to  vouch 
for  him.  Seeing  things  from  a  less  acute  angle,  teachers  are  able 
to  throw  a  clearer  if  less  intense  light  upon  the  family  characteristics 
than  comes  from  more  personal  sources. 

In  nearly  all  of  100  widows-with-children  records  examined  by  the  writer,  the 
school  had  been  visited,  though  only  once,  by  investigators  who  were  studying 
the  administration  of  a  public  pension  to  mothers.  Twenty  of  these  records  have 
been  taken  at  random  and  examined  with  reference  to  this  question  of  the  new  light, 
if  any,  that  can  be  thrown  on  home  problems  by  a  single  visit  to  the  school.  There 
were  52  children  of  school  age  in  the  20  families.  The  department  administering 

1  For  a  questionnaire  regarding  a  Neglected  Child,  see  Part  III,  p.  405. 

229 


SOCIAL  DIAGNOSIS 


the  pensions  had  consulted  the  school  previous  to  the  special  inquiry  in  one  of  the 
20  cases;  and  in  9  of  the  20  no  new  light  on  the  home  as  a  whole  was  had  by  the 
special  investigator’s  school  visit.  In  the  remaining  11  the  following  results  were 
obtained:  In  one  the  teacher  agreed  to  see  that  there  was  no  longer  an  excuse  for 
the  absence  of  an  older  sister  by  taking  the  youngest  child  into  the  school.  In 
five  the  need  of  these  enumerated  readjustments  was  made  evident:  (1)  change  of 
mother’s  work,  (2)  mother  must  show  more  interest  in  children’s  condition,  (3) 
children’s  breakfast  must  be  prepared,  (4)  older  children  must  be  sent  to  school 
much  more  regularly,  (5)  special  care  needed  in  diet  of  children.  In  five  families 
the  home  care  was  discovered  to  be  especially  good,  and  in  one  of  these  five  the 
mother  had  been  to  the  school  on  her  own  initiative  to  discover  how  the  children 
were  progressing.  It  will  be  seen  that  all  of  these  items  have  a  direct  bearing  upon 
any  plans  for  family  relief  or  other  care.  They  are  fairly  representative  of  the  con¬ 
tribution  that  the  school  can  make  in  case  work.  Three-fourths  of  the  schools 
visited  were  public  and  the  rest  parochial. 

A  boy  whose  conduct  in  class  was  excellent  but  whose  attendance  was  irregular 
made  his  teacher  suspicious  that  home  conditions  were  not  all  right  by  often  falling 
asleep  in  school.  A  home  and  school  visitor  was  asked  to  look  into  the  matter,  and 
discovered  that  the  boy’s  stepfather  was  sending  him  out  early  to  sell  papers,  and 
punishing  him  severely  when  he  failed  to  return  with  a  certain  amount  daily. 
Many  interviews  were  held  with  the  stepfather  himself,  who  found  the  visitor  willing 
to  listen  to  his  own  difficulties  and  to  help  him  to  more  regular  work,  but  quite  de¬ 
termined  to  protect  the  boy.  The  newspaper  selling  was  stopped,  the  boy  sent  to 
the  country  for  a  month,  and  his  scholarship  after  his  return  markedly  improved. 
The  investigation  as  to  the  home’s  share  in  the  boy’s  condition  did  not  center  around 
this  one  fact  of  neglect — it  could  not  if  he  was  to  remain  with  his  own  people — and, 
by  pushing  beyond  into  the  industrial  and  other  factors,  the  home  itself  was  very 
much  improved. 

8.  Results  of  Social  Treatment.  The  elements  with  which  social 
work  has  to  deal  are  so  many  and  so  intermingled  that  any  tests 
of  the  results  of  the  work  itself  are  applied  with  difficulty.  It  is 
possible  for  our  clients  to  fulfill  one  or  another  condition  urged 
upon  them  from  without,  or  to  appear  to  fulfill  it,  without  any 
essential  change  of  goal.  Here  once  again,  in  this  matter  of 
measuring  results  and  testing  the  efficiency  of  case  work,  the  co¬ 
operation  of  the  teacher  who  knows  his  children  well  would  be 
invaluable,  especially  to  the  family  agencies.  On  such  a  date,  at 
the  beginning  of  social  treatment,  the  children  of  the  family  exhib¬ 
ited,  from  the  school  point  of  view,  such  and  such  characteristics. 
After  so  many  months  of  family  treatment,  the  children,  under 
conditions  of  observation  that  are  practically  identical,  show  what 
changes,  if  any?  Not  all  of  these  changes,  favorable  or  unfavor- 

230 


SCHOOLS  AS  SOURCES 


able,  could  be  credited  to  or  charged  against  the  family  agency, 
but  the  connection  between  its  work  and  this  group  of  results 
could  be  studied  carefully  and  a  reasonably  accurate  balance 
could  be  struck. 

In  so  far  as  general  inquiries  and  requests  for  special  observa¬ 
tions  put  any  new  burden  whatsoever  upon  the  teachers,  we  must 
be  at  great  pains  to  see  that  the  thorough  putting  through  of  our 
own  task  really  helps  theirs.  In  some  cities  there  have  been  board 
of  education  rules  requiring  that  all  access  to  teachers  must  be  by 
letter.  In  one,  for  a  little  while,  the  rule  was  promulgated,  even, 
that  no  public  school  teacher  should  give  any  information  to  a 
social  agency.  The  results  were  so  disastrous  in  their  effects  upon 
school  work  that  the  rule  was  soon  set  aside.  No  teacher  should 
be  called  from  his  class-room  work  to  answer  a  question  that  some¬ 
one  else  can  answer  just  as  well;  when  the  record  contains  what  is 
wanted,  the  record  should  be  made  to  serve.  No  routine  ques¬ 
tions  asked  for  the  sake  of  filling  out  a  face  card  and  leading  no¬ 
where  should  be  allowed  to  interrupt  his  busy  day.  But  the  co¬ 
operative  result  in  which  the  social  agency  helps  the  school  quite 
as  much  as  the  school  the  agency  is  the  thing  to  aim  for.  Any¬ 
thing  that  influences  the  character  of  a  child  must  concern  its 
teachers.  They  are  concerned  with,  though  not  directly  responsi¬ 
ble  for,  improvement  in  home  conditions;  they  are  interested  in 
the  segregation  of  the  mentally  defective;  in  the  cure  and  preven¬ 
tion  of  physical  and  mental  disease;  in  the  reduction  of  irregular 
school  attendance,  improper  and  under-feeding,  and  dead-end 
occupations;  in  the  abolition  of  premature  employment;  and  in 
the  prevention  of  that  waste  of  unusual  ability  which  comes  from 
lack  of  longer  training.  It  would  be  foolish  to  make  teachers  re¬ 
sponsible  for  these  reforms,  but  they  are  vitally  interested  in  them. 
From  the  illustrations  already  given  it  is  evident  that  social  workers 
are  interested  too — are  deeply  interested  in  all  of  them,  and  have 
already  borne  no  small  part  in  the  improvements  achieved  in  these 
very  directions.  To  utilize  to  the  full  this  common  interest  is  a 
fundamental  part  of  the  technique  of  consultation  with  School 
Sources. 

School  Sources  of  information  are  among  the  very  best,  but  every 
source  has  the  defects  of  its  qualities.  Teachers  see  home  condi- 

231 


SOCIAL  DIAGNOSIS 


tions  from  one  point  of  view  only,  and,  unless  they  have  had  oc¬ 
casion  to  think  of  human  relations  in  disadvantaged  families  from 
other  angles  also,  they  are  liable  to  fall  into  the  error  of  thinking 
that  any  home  adjustment  which  meets  school  needs,  even  tempo¬ 
rarily,  must  be  the  right  one. 

A  large  institution  for  orphans  or  half-orphans  finds  that  the  testimony  of  teachers, 
though  absolutely  necessary,  is  often  biased  by  the  idea  that  certain  statements  will 
get  the  child  into  the  institution  and  that  certain  others  will  keep  him  out.  If 
the  teacher  is  “sorry  for  his  mother,”  or  eager  to  get  a  troublesome  pupil  out  of  her 
classes  (to  give  two  reasons  often  encountered),  her  personal  bias  even  leads  some¬ 
times  to  suppressions  or  misstatements  of  fact.  A  number  of  records  submitted 
for  study  illustrate  this.  The  misstatements  are  more  often  made  on  the  applica¬ 
tion  blank,  however.  When  seen  face  to  face,  with  an  opportunity  to  have  explained 
to  her  the  real  uses  of  the  institution  and  the  possible  alternative  plans,  in  case  the 
application  is  rejected,  she  is  usually  quite  frank,  both  in  her  description  of  the 
pupil’s  characteristics  and  in  her  explanations  of  her  former  statements. 


II.  METHOD 

A  probation  officer  finds  that  she  secures  definite  vantage  ground 
for  a  first  interview  with  the  parents  of  a  boy  or  girl  of  school  age 
who  has  been  arrested,  by  going  first  to  the  school.  She  gets  what 
she  can  about  age,  disposition,  physical,  mental,  and  moral  calibre, 
from  the  child’s  own  teacher,  and  also  such  information  as  the 
teacher  has,  though  this  is  often  very  incomplete,  about  relatives 
and  home  conditions. 

Needless  to  say,  such  inquiries — any  inquiries  in  fact — must  not 
be  made  in  the  hearing  of  the  other  children,  or  in  such  a  way  as  to 
attract  their  attention.  Sometimes  school  officials  do  not  seem 
to  realize  the  dangers  of  public  questioning  and  public  discussion 
of  home  and  personal  affairs — a  principal  will  send  for  a  child  and 
question  him,  if  not  before  his  own  class,  then  before  another. 
This  must  be  discouraged,  of  course. 

It  is  difficult  to  make  any  suggestions  about  the  choice  between 
seeing  principals  and  seeingdndividual  teachers  that  could  be  ap¬ 
plied  to  all  school  systems.  In  some  cities,  social  workers  always 
go  to  the  principal  first,  who  calls  the  teacher  if  necessary.  The 
principal  may  know  other  children  in  the  family,  and  the  teacher 
only  the  one  child;  the  principal  has  the  record,  but  the  individual 
teacher,  on  the  other  hand,  has  had  better  opportunity  of  observing 

232 


SCHOOLS  AS  SOURCES 


evidences  of  home  training,  and  of  noting  the  health  and  personal 
characteristics  of  his  pupil. 

Whenever  information  of  value  has  been  procured  from  a  teacher 
that  has  later  been  put  to  use  with  definite  results,  or  whenever 
new  developments  or  new  plans  might  possibly  be  of  interest  to 
him,  the  opportunity  should  not  be  lost  of  showing  how  his  work 
is  related  to  that  of  the  social  worker^  A  letter  writtenfa  message 
sent,  or  a  visit  paid  may  increase  co-operation  later.  Many  failures 
in  co-operation  are  directly  due  to  the  failure  to  knit  more  closely 
the  temporary  contacts  and  natural  introductions  that  come 
through  case  work. 

It  sometimes  happens  that  a  social  agency  is  able  to  justify 
and  explain  a  teacher’s  position,  where  it  has  been  misunderstood, 
as  in  the  following  instance: 

A  boy  of  twelve  who  became  insane  seemed  to  have  been  particularly  excited 
over  his  school  teacher’s  cruelty.  The  family  and  the  family  doctor  (a  neighbor¬ 
hood  practitioner)  were  inclined  to  feel  bitterly  toward  the  school.  The  medical- 
social  service  department  interested  in  the  case  made  an  investigation  and  became 
convinced  that  the  boy’s  school  treatment  had  been  good.  The  department’s 
record  adds,  “Letter  written  to  family  doctor  explaining  to  him  that  investigation 
made  by  social  service  does  not  reveal  any  abuse  in  the  school.  Social  service  is 
anxious  for  him  to  understand  this,  as  he  might  be  influential  in  the  neighborhood 
in  correcting  any  misapprehension.” 

Whatever  has  been  said  here  about  the  utilization  of  the  edu¬ 
cator’s  experience  and  point  of  view  applies  equally,  of  course,  to 
home  and  school  visitors,  to  teachers  in  settlements,  to  boys’  and 
girls’  club  workers,  directors  of  playgrounds  and  recreation  centers, 
librarians  of  children’s  rooms  in  public  or  special  libraries,  and  to 
Sunday  school  teachers.  Fellow  pupils  must  be  consulted  in  a 
few  child-protective  tasks,  and  the  characteristics  of  companions 
and  of  the  gang  leader  (where  there  is  one)  must  be  taken  into  ac¬ 
count  in  many  of  them. 

Last  of  all,  it  should  be  noted  that  a  certain  lack  of  sympathy 
and  understanding  as  between  home  and  school  has  been  due,  in 
part,  to  the  very  scale  upon  which  our  educational  processes  have 
been  carried  on.  Definite  steps,  also  on  a  large  scale,  are  being 
taken  to  overcome  this,  but  every  social  worker  who  enters  a  home 
often  and  also  knows  the  school  to  which  its  children  are  sent 
should  be  striving  to  make  the  home  more  helpful  to  the  school. 

233 


SOCIAL  DIAGNOSIS 


SUMMARY  OF  THIS  CHAPTER 

1.  The  teacher  who  is  the  best  educator,  who  is  able  to  individualize  his  pupils 
and  adapt  his  teaching  to  their  needs  and  capabilities,  is  the  best  social  witness. 

2.  The  failings  of  teachers  as  social  witnesses  are  traceable  to  those  school  con¬ 
ditions  which  make  any  individualization  of  their  pupils  impossible,  and  to  their 
tendency  to  think  that  whatever  social  adjustment  meets  school  needs,  even 
temporarily,  must  be  the  right  one. 

3.  The  social  evidence  of  teachers  may  be  classified  under  evidence  about  (1) 
grade,  (2)  scholarship,  (3)  attendance,  (4)  behavior,  (5)  physical  condition,  (6) 
mental  condition,  (7)  home  care,  (8)  results  of  social  treatment. 

4.  Grade  means  little  except  in  relation  to  other  facts,  such  as  age  of  child  when 
first  entered  at  school,  the  family  removals  from  city  to  city,  school  absences  due  to 
sickness,  child’s  knowledge  of  the  English  language,  etc. 

5.  A  general  scholarship  mark  is  not  so  significant  as  are  marks  showing  relative 
standing  in  different  studies,  and  these  agaifi  are  not  so  significant  as  the  teacher’s 
own  observations  of  the  child’s  mental  reactions.  C 

6.  Behavior  covers  something  more  than  can  be  shown  by  a  conduct  mark.  We 
must  learn  to  seek  for  the  description  of  the  child’s  “acts,  motives,  desires,  ten¬ 
dencies.” 

7.  Certain  individual  variations  in  children  that  are  due  to  physical  or  nervous 
disturbance  are  evident  only  to  one  who  has  them  under  observation  continuously. 
Teachers  are  in  a  better  position  to  give  this  evidence  than  anyone  else,  unless  some 
members  of  the  child’s  family  happen  to  be  good  observers. 

8.  School  evidence  must  play  an  important  part  in  the  discovery  and  segrega¬ 
tion  of  defectives. 

9.  Teachers  who  have  never  seen  the  homes  of  their  pupils  are  able  nevertheless 
to  give  excellent  witness  as  to  the  signs  of  good  home  nurture  and  those  of  home 
neglect. 

10.  As  a  measure  of  the  results  of  social  treatment  in  the  home,  a  teacher’s 
testimony  taken  at  the  beginning  of  treatment  and  at  intervals  later  would  have 
definite  value. 

11.  As  with  medical  sources,  careful  social  reporting  to  School  Sources  by  case 
work  agencies  and  brief  supplementary  reporting  on  new  developments  later, 
strengthens  co-operative  relations. 


234 


I 


CHAPTER  XII 


EMPLOYERS  AND  OTHER  WORK  SOURCES 

EVERY  period  of  the  world’s  history  is  a  period  of  transition, 
of  course,  yet  the  institutions  with  which  the  social  worker 
has  to  deal  seem  to  be  changing  at  a  far  more  rapid  rate  in 
our  own  day  than  in  any  other.  Developments  that  have  been 
continuous  but  hidden  are  now  at  last  bearing  visible  fruit.  In 
the  hospital,  the  school,  and  the  workshop  reorganizations  are 
in  process  that  should  soon  make  the  doctor,  the  teacher,  and  the 
Employer  more  effective  agents  of  social  advance  and  better 
witnesses  in  the  gathering  of  social  evidence  than  they  have  ever 
been.  The  Employer  differs  from  the  teacher  and  the  doctor,  \ 
however,  in  that  he  is  farther  removed  in  daily  habit  from  social-  i 
ized  action,  and  is  often  controlled  by  quite  another  set  of  motives./ 
Even  when,  as  sometimes  happens,  his  motives  are  completely 
social,  this  fact  is  not  easily  recognized,  because  he  is  hampered  by 
imperfect  forms  of  industrial  organization.  By  the  earlier  kinds 
of  social  work,  Employers  were  used  habitually  as  a  favorite  “  refer¬ 
ence”  to  vouch  for  clients  in  a  general  way  as  worthy  or  unworthy, 
industrious  or  lazy,  sober  or  drunken.  Like  most  things  that  we 
have  always  done,  our  regular  practice  of  consulting  with  these 
industrial  sources  has  become  perfunctory.  The  case  illustra¬ 
tions  at  hand  show  even  less  constructive  planning  on  the  industrial 
side  than  on  the  health  and  educational  sides.  There  are  probably 
other  reasons  for  this  than  that  the  social  agencies  have  been  doing 
an  old  thing  in  an  old  way.  Changes  from  small  industrial  plants 
to  large  ones,  with  the  corresponding  multiplication  of  middle¬ 
men,  and  the  almost  complete  failure  to  individualize  the  laborer 
in  most  of  our  wholesale  processes,  have  made  it  increasingly  diffi¬ 
cult  to  get  the  information  that  may  be  had  about  his  work,  and 
the  information  that  may  be  had  is  less  revealing. 

There  are  signs  from  many  quarters  that  the  handling  of  labor 
as  though  it  were  scrap  iron  is  soon  to  end,  and  that  the  workshop 

235 


SOCIAL  DIAGNOSIS 


of  the  future  will  be  supervised  by  trained  observers,  who  will  be 
far  more  keenly  alive  to  mental  and  temperamental  differences 
than  the  small  Employer  ever  was.  Our  immediate  business,  how¬ 
ever,  is  not  to  indulge  in  prophecy,  but  to  consider,  first,  the  scope 
and  use  of  a  work  record;  second,  certain  failures  of  Employer 
testimony  regarded  as  social  evidence;  third,  differences  in  the 
social  worker’s  relations  to  former,  to  present,  and  to  prospective 
employers;  fourth,  methods  of  approach  in  different  types  of  cases; 
and  last,  miscellaneous  work  sources — those  other  than  Employers. 

I.  USES  AND  SCOPE  OF  A  WORK  RECORD 

1.  Uses.  The  least  constructive  use  of  any  source  of  informa¬ 
tion  is  merely  to  verify  another  source.  An  extreme  instance 
would  be  that  of  the  visitor  who  returned  to  a  family  agency  with 
an  air  of  satisfaction  and  the  sole  statement,  “Well,  I  find  the  man 
did  work  for  the  firm  that  he  said  he  worked  for.”  Verification  is 
necessary,  but  usually  it  should  be  merely  the  by-product  of  more 
fruitful  inquiries. 

The  ancient  Teutonic  trials  (which  were  not  trials  in  the  modern 
legal  use  of  the  word)  were  often  by  ordeal.  If  the  accused  per¬ 
formed  the  ordeal,  he  won;  if  he  failed,  he  lost.1  Comparable  to 
this  rude  justice  is  the  work  test  of  modern  charity,  which  soon 
ceases  to  be  a  test,  even,  and  becomes  a  doling  out  of  woodyard  or 
other  work  tickets  as  a  substitute  for  discovering  the  right  thing 
to  do.  There  is,  however,  a  place  for  the  test  which  is  carefully 
planned  to  reveal  capacity  when  it  is  not  discoverable  by  other 
means — for  investigation  by  experiment,  as  it  may  be  called.  An 
interested  Employer,  who  understands  the  end  in  view,  may  be 
helpful  here  in  creating  conditions  that  make  the  test  a  fair  one. 

Beyond  the  formal  verification  of  a  statement  or  the  testing  of 
a  man’s  willingness  to  do  any  work  whatever,  the  reasons  for  study¬ 
ing  a  client’s  work  record  are  many  and  various. 

In  the  first  place,  if  unemployed,  that  fact  alone  does  not  classify 
him.  He  may  be  a  man  who  has  held  a  permanent  situation  for  a 
long  time  and  lost  it  through  some  change  in  the  nature  or  organiza¬ 
tion  of  the  industry;  he  may  be  accustomed  to  discontinuous  work 
lasting  longer  or  shorter  periods  but  with  necessary  breaks  between 

1  Encyclopedia  Britannica,  Eleventh  Edition.  Article  on  Evidence. 

236 


EMPLOYERS  AND  OTHER  WORK  SOURCES 


the  jobs;  he  may  be  a  casual  laborer  who  is  chronically  under¬ 
employed,  who  works  only  a  few  days  in  each  week;  or  he  may 
be  unemployable.1 

In  the  second  place,  industrial  conditions,  though  we  speak  of 
them  in  the  mass  as  good  or  bad,  are,  within  limits,  as  various  as 
the  conditions  of  the  composite  group  of  the  unemployed,  and  are 
quite  as  much  in  need  of  analysis  if  we  are  to  replace  or  to  advance 
an  unemployed  workman.  Studies  made  within  the  last  decade  show 
how  little  work  conditions  have  been  standardized2  and  how  various 
are  wages  and  industrial  environment  in  the  same  processes  of  the 
same  industry.  “  The  bearing  of  this  on  individual  case  treatment,” 
writes  Miss  Mary  Van  Kleeck,  in  a  paper  addressed  to  charity 
organization  workers,3  “is  obvious.  Because  the  average  wage  of 
women  in  factories  in  our  community  is  $6.00  a  week  is  no  reason 
for  being  content  with  supplementing  from  charitable  sources  a 
working  woman's  earnings  of  $ 6.00  in  a  cigar  factory,  when  a 

1  For  a  discussion  of  these  classes  of  the  unemployed  from  the  English  point  of 
view,  see  second  volume  of  Minority  Report  of  the  English  Poor  Law  Commission: 
The  Public  Organization  of  the  Labor  Market,  Chapter  IV,  pp.  163-230. 

2  Thus,  from  the  1912  report  of  the  Massachusetts  Commission  on  Minimum 
Wage  Boards  it  appears  that  in  the  candy  industry  one  factory  paid  no  woman  or 
girl  less  than  $5.00,  while  69.6  per  cent  of  its  women  and  girl  employes  received 
$8.00  or  more;  in  two  other  factories,  on  the  other  hand,  30  per  cent  and  47  per 
cent  respectively  of  the  women  employes  received  less  than  $4.00  while  only  7  per 
cent  and  3  per  cent  were  paid  as  much  as  $8.00.  Not  all  of  these  factories  were 
situated  in  the  same  community,  but  the  contrast  was  nearly  as  great  in  the  case  of 
six  department  stores  in  Boston  where  the  percentage  of  female  employes  receiving 
under  $4.00  varied  from  1  to  24  per  cent,  while  from  13  to  58  per  cent  received  $8.00 
or  more;  and  in  the  case  of  13  laundries  in  Boston  and  Cambridge,  in  which  from 
o  to  29  per  cent  of  women  and  girls  received  under  $4.00  and  from  o  to  45  per  cent, 
$8.00  or  over.  (See  pages  62,  1 18-1 19,  and  160.)  A  similar  state  of  affairs  in  the 
millinery  trade  was  revealed  by  the  New  York  State  Factory  Investigating  Com¬ 
mission  (Fourth  Report,  1915,  Vol.  II,  pp.  437-439); and  the  United  States  Bureau 
of  Labor’s  Report  on  Conditions  of  Employment  in  the  Iron  and  Steel  Industry  in 
the  United  States  (1913)  gives  the  results  of  a  study  of  wages  paid  in  the  Pittsburgh 
district  which  reveals  notable  contrasts  as  between  the  different  concerns.  (Vol. 
Ill,  pp.  261-267.) 

Furthermore,  factories  in  the  same  industry  differ  greatly  in  the  extent  to  which 
the  size  of  their  working  force  varies  from  month  to  month.  Thus  in  12  Massa¬ 
chusetts  candy  factories  the  minimum  force  employed  in  any  month  varied  from 
22.7  per  cent  to  76  per  cent  of  the  maximum  force.  (Minimum  Wage  Report,  p. 
67.)  A  similar  variation  in  18  large  retail  stores  in  New  York  is  revealed  by  the 
New  York  Factory  Investigating  Commission’s  Fourth  Report  (p.  607),  where  it 
appears  that  the  minimum  force  employed  forms  anywhere  from  47  to  85  per  cent  of 
the  maximum  force.  Similar  conditions  prevail  in  the  men’s  clothing  trade,  as  may 
be  seen  by  consulting  the  United  States  Bureau  of  Labor’s  Report  on  Condition  of 
Woman  and  Child  Wage-earners  in  the  United  States,  1911,  Vol.  II,  pp.  1 74—179. 

3  One  of  the  short,  unpublished  papers  referred  to  in  the  Preface. 

237 


SOCIAL  DIAGNOSIS 


frank  talk  with  her  employer  or  her  transfer  to  another  factory 
would  increase  her  wages/'  Fatalism  is  too  common  on  the  in¬ 
dustrial  side  of  social  case  work. 

“This  is  a  case,”  says  a  critic  of  a  certain  family  record,  “where  the  husband  is 
working  as  driver  for  a  trucking  company  and  is  only  paid  when  there  is  work  on 
hand,  but  has  to  report  every  day.  No  attempt  is  made  to  straighten  out  this 
matter  by  making  a  further  investigation  into  the  man’s  industrial  record,  to  learn 
whether  the  case  committee  should  not  advise  him  to  look  for  other  work  and  pos¬ 
sibly  assist  in  this  direction.  His  is  just  the  sort  of  irregular  work  in  which  his 
tendency  to  drink  may  get  the  better  of  him,  and  he  appears  to  be  of  good  stuff, 
well  worth  rehabilitating  now  instead  of  waiting  until  things  get  worse.” 

The  same  critic  says  of  another  case,  “This  man  has  been  allowed  to  get  down  to  a 
$12  a.  week  income,  and  is  in  an  occupation  which  does  not  hold  promise  of  advance¬ 
ment.  I  believe  there  should  be  a  consultation  with  the  former  employers  to  learn 
how  skilled  he  is,  and  whether  at  a  later  date  he  should  be  encouraged  to  make 
efforts  to  get  back  into  his  former  occupation.” 

And  of  still  another  case  he  writes,  “Here  is  a  man  who  has  been  in  this  country 
for  twelve  years,  and  is  said  to  be  earning  only  $3.00  or  $4.00  a  week.  That  is 
something  which  requires  righting.  Somewhere  and  somehow  the  real  life  of  the 
family  and  condition  of  the  man  can  be  revealed.” 

In  the  third  place,  advancement  as  well  as  reinstatement  must 
be  the  aim,  and  for  this  the  facts  are  needed.  The  prospective 
employer  is  more  easily  interested  by  one  who  has  the  facts  of 
work  history.  Even  where  the  Employer  is  indifferent  to  them, 
there  is  loss  of  influence  with  him  and  nothing  but  loss  to  the  work¬ 
man  when  we  recommend  the  latter  for  a  kind  of  work  that  he  is 
incapable  of  keeping. 

In  the  fourth  place,  the  former  employer  is  not  merely  a  means 
of  completing  our  work-history  record,  he  is  not  just  a  source  but 
is  often  a  resource,  and,  in  most  interviews  with  him,  the  possi¬ 
bility  of  reinstatement  must  be  kept  in  view.  With  the  present 
employer,  where  sickness  of  the  workman  is  not  the  trouble,  but 
where  he  is  failing  to  spend  his  wages  on  his  family,  the  chance  of 
persuading  his  Employer  to  “trustee"  the  wages  or  to  bring  in¬ 
fluence  to  bear  in  some  other  way  is  worth  considering.  Thus 
the  two  purposes  of  social  diagnosis — first  to  arrive  at  as  exact 
a  definition  as  possible  of  the  difficulty,  and  second  to  assure  that 
this  definition  is  so  procured  that  it  can  be  followed  by  effective 
and  co-operative  action — help  one  another  and  are  to  be  developed 
simultaneously. 


238 


EMPLOYERS  AND  OTHER  WORK  SOURCES 


2.  Scope.  Having  regard  to  the  gathering  of  data  only,  the 
following  is  a  fuller  outline  than  will  be  necessary  in  the  study  of 
any  one  work  record.  Like  all  the  outlines  in  this  book  it  is  in¬ 
tended  to  be  suggestive  and  is  not  a  schedule  to  be  filled  out.  Nor 
is  all  the  information  indicated  to  be  procured  from  any  one  source 
— a  comparison  of  the  statements  of  client  and  of  Employer  will 
lead  to  correction  of  the  inaccuracies  of  each. 

Names  and  addresses  of  former  employers. 

Nature  of  occupation  or  occupations  with  each  former  employer  (first  the  in¬ 
dustry,  then  the  exact  process  engaged  in,  for  it  is  necessary  to  have  both). 

Between  what  dates  employed. 

If  large  concerns,  worker’s  number,  department,  and  foreman. 

Wages  earned  at  each  place. 

Worker’s  record  at  each  for  speed,  accuracy,  regularity,  sobriety;  relations  with 

fellow  workmen;  peculiarities  of  habit  and  temper  revealed. 

For  present  occupation,  the  foregoing,  and — 

Week’s  work  or  piece  work. 

Full,  seasonal,  occasional,  or  part-time  work  (if  seasonal,  how  many  weeks  lost 
in  a  year). 

Hours  of  work  daily  and  weekly,  and  amount  of  overtime. 

Nature  of  the  material  worked  in  and  healthfulness  of  the  process. 

Sanitation  and  safety  of  surroundings. 

Opportunities  for  advancement. 

Full  analysis  of  wages  (how  much  when  working  full  time,  amount  of  fines, 
of  overtime  pay,  of  gratuities,  commissions,  or  bonuses;  earnings  at  present 
allowing  for  part  time  if  any,  etc.). 

Is  there  a  mutual  benefit  society  or  an  insurance  system  in  connection  with  the 
establishment? 

If  the  employe  is  sick,  what  assistance  has  been  given  by  Employers?  by  fel¬ 
low  workers? 

If  out  of  work,  how  long  and  cause  of  leaving  last  employment. 

Time  out  of  work  during  last  twelve  months. 

Age  at  which  first  went  to  work,  nature  of  work,  nature  of  preparation. 

For  the  relation  of  the  facts  suggested  in  this  outline  to  the  other 
social  facts  of  a  family  history,  see  questionnaire  on  Any  Family 
in  Part  1 1 1  and  the  questionnaires  that  follow  it  on  a  Deserted 
Family,  Inebriety,  and  a  Homeless  Man.  Where  any  of  these 
three  conditions  complicate  the  task,  there  are  important  varia¬ 
tions  in  the  ground  to  be  covered. 

Under  a  Deserted  Family,  for  example,  these  questions  among  others:  What 
opportunities  for  development  did  man’s  earliest  occupations  give  him?  Has  his  wife 
worked  since  marriage  and  if  so  the  effect  on  her  health,  on  his  wage-earning,  on 

239 


SOCIAL  DIAGNOSIS 


the  home,  on  the  children?  Have  his  children’s  earnings  had  any  effect  in  les¬ 
sening  the  father’s  sense  of  responsibility? 

Under  Inebriety  the  following:  Has  the  patient  met  with  business  reverses? 
Does  the  nature  of  his  employment  expose  him  to  temptation?  Does  he  work  long 
hours  in  extremes  of  temperature?  Does  he  work  under  trying  conditions  of  dust 
or  ill  ventilation?  Has  his  wife  been  forced  to  become  a  wage-earner? 

Under  a  Homeless  Man:  Was  he  ever  a  newsboy  or  messenger?  First  occupation, 
its  nature  and  wages.  Did  he  ever  learn  a  trade?  Longest  time  at  any  one  job. 
What  does  he  consider  his  true  occupation?  How  long  ago  was  his  last  work?  If  his 
work  has  usually  been  seasonal,  how  has  he  been  accustomed  to  live  between  jobs? 

II.  CERTAIN  FAILURES  OF  EMPLOYER  TESTIMONY 

The  comparison  of  sources  on  page  1 66,  Table  2,  shows  that 
(omitting  other  social  agencies  as  a  source,  since  these  bear  a 
different  relation  to  diagnosis)  Employers  stand,  in  frequency  of 
use,  as  follows: 

First  City  Second  City  Third  City 
Former  employers  5th  7th  6th 

Present  employers  10th  10th  9th 

This  shows  greater  uniformity  of  practice  than  in  the  use  of  any 
other  one  source,  with  the  possible  exceptions  of  dispensaries  and 
relatives.  Present  are  not  consulted  so  frequently  as  former  em¬ 
ployers.  Is  this  due  solely  to  the  fact  that,  in  cases  of  unemploy¬ 
ment,  there  are  no  present  employers,  and  that  former  employers 
are,  case  by  case,  more  numerous?  In  the  2,800  cases  examined, 
former  employers  were  communicated  with  470  times  as  against 
232  consultations  with  present  employers.  Interviews  with  case 
workers  and  a  study  of  their  records  reveal  another  reason  for  the 
difference.  Former  employers  can  be  seen  with  far  less  danger  of 
injuring  a  client’s  industrial  relations  and  status.  They  are  ac¬ 
customed  to  be  used  as  work  references,  and  no  prejudice  is  created 
by  the  inquiry  if  it  is  made  with  any  discretion.  The  information 
that  they  are  able  to  supply  often  makes  communication  with  a 
present  employer  unnecessary,  though  this  is  not  invariably  the 
case,  as  will  appear  later. 

What  can  be  said,  in  general,  of  the  social  evidence  value  of 
Employer  testimony?  Employers’  statements  have  greatest  value 
,in  matters  strictly  industrial,  and  are  too  often  quoted  in  social 
records  as  conclusive  with  regard  to  matters  about  which  their 
knowledge  is  merely  hearsay. 


240 


EMPLOYERS  AND  OTHER  WORK  SOURCES 


As  to  home  conditions,  the  character  of  the  wife,  etc.,  the  “shop” 
usually  know  what  the  breadwinner  of  the  family  has  told  them 
and  no  more.  This  does  not  mean  that  work  references  can  give 
no  evidence  of  value  on  these  matters,  but  that  the  usual  tests 
should  be  applied — the  identity  of  the  original  informant  must  be 
known,  and  any  signs  of  bias  must  be  noted. 

An  Employer  sometimes  states  the  maximum  earnings  at  full 
time,  or  names  the  rate  at  which  a  workman  is  paid,  without  giving 
(unless  specifically  asked)  the  number  of  hours  actually  worked. 
“The  most  accurate  way,”  says  Miss  Sears,  “is  to  know  what  his 
[the  employe's]  last  pay  envelope  contained.”1  The  only  way  to 
be  absolutely  sure  of  this,  of  course,  is  to  see  the  envelope. 

Letters  of  former  employers  about  a  workman  addressed  “to 
whom  it  may  concern”  are  valueless;  they  express  too  often  the 
good  natured  relief  of  one  who  is  well  rid  of  a  burden,  while  a  pres¬ 
ent  employer  is  sometimes  tempted  to  conceal  the  truth  about  a 
particularly  useful  employe.  These  two  forms  of  bias  are  illus¬ 
trated  in  the  following  instances: 

A  man’s  Employer  wrote,  “This  is  to  certify  that - has  worked  for  me  off 

and  on  for  the  last  four  years.  His  work  has  been  very  satisfactory,  and  he  is  a 
thoroughly  good,  all-round  man,  and  I  think  you  will  find  him  very  valuable.” 
The  man’s  foreman,  when  seen  later,  said  that  he  was  a  plausible  fellow  who  im¬ 
pressed  everybody  favorably  at  first,  but  who  spent  his  money  as  fast  as  he  got  it  on 
drink  and  on  women.  Had  once  said  that  he  was  married  but  later  denied  it.  His 
Employer  wrote  the  letter  because  he  was  “down  and  out,”  and  no  one  wanted  to 
give  him  another  knock.  This  client  had  tuberculosis  and  needed  care,  but  the  form 
that  the  care  took  had  to  be  modified  by  the  existence  of  a  wife  and  children  (he 
had  claimed  to  be  single),  and  by  the  presence  of  inebriety  and  syphilis — conditions 
all  brought  to  light  in  the  course  of  inquiry. 

An  Italian  widow  with  children,  who  claimed  that  their  only  support  came  from 
a  sister  of  hers  who  worked  for  a  tailoress  for  $2.00  or  $3.00  a  week,  had  her  story 
confirmed  by  the  sister’s  Employer.  Later  the  payrolls  of  the  shop  showed  that 
these  two  women  and  the  daughter  of  one  of  them  (whose  whereabouts  had  been 
reported  unknown)  had  been  earning  steadily  from  $10  to  $18  a  week,  and  that  their 
average  earnings  had  been  between  $12  and  $13.  Various  charities  and  individuals 
had  supported  the  family  meanwhile,  at  the  request  of  the  charity  organization 
society.  The  tailoress  explained  that  she  knew  that  help  which  was  not  needed 
was  being  given;  but  the  women  were  so  valuable  to  her  that  she  could  not  afford 
to  offend  them. 

1The  Charity  Visitor,  p.  31. 


16 


241 


SOCIAL  DIAGNOSIS 


III.  THE  CO-OPERATION  OF  EMPLOYERS 

1.  Former  Employers.  The  former  employer  may  be  an  un¬ 
satisfactory  writer  of  letters  of  recommendation, ‘but  when  seen  in 
his  own  surroundings,  where  payrolls,  foremen,  and  shop  mates 
can  be  consulted,  or  where  it  is  possible  to  refer  the  inquirer  to 
one  or  the  other  of  these,  his  evidence  assumes  a  very  different 
character,  especially  when  he  is  not  too  busy  to  hear,  in  a  few  words, 
the  circumstances  and  plans  that  give  his  own  statement  a  definite 
value.  By  showing  the  relation  of  his  testimony  to  constructive 
work  that  is  in  progress,  it  is  often  possible  to  interest  him  in  the 
future  of  his  old  workman  and  in  the  family’s  future  too.  Some¬ 
times  the  former  employer  becomes  the  prospective  employer. 
Where  there  is  a  good  chance  of  this,  he  should  be  seen  quite  late 
in  the  course  of  the  outside  inquiries,  to  spare  him  a  second  visit, 
if  possible,  and  to  make  his  co-operation  fit  in  with  the  other  plans 
developed  by  consultation.1  The  degree  of  interest  felt  and  ex¬ 
hibited  by  the  inquirer,  and  the  amount  of  knowledge  of  the  real 
situation  that  he  shows  will  have  a  direct  relation  to  the  kind  of 
co-operation  secured. 

An  office  for  the  care  of  the  homeless  and  transient  poor  reported  one  of  its  appli¬ 
cants  as  the  “raggedest  creature  that  ever  came  in  here.”  The  man  had  only  one 
leg,  his  artificial  leg  was  broken,  he  last  worked  for  a  contractor  as  teamster,  and 
had  a  record  of  drink.  The  former  employer  was  induced  to  take  him  back  and  to 
pay  $5.00  a  week  out  of  the  man’s  wages  toward  $50  advanced  by  the  agency  to  buy 
another  leg.  This  was  in  May.  In  August  the  man  had  one  lapse,  was  arrested  for 
drunkenness  and  neglected  to  pay  his  fine.  When  re-arrested  the  Employer  paid 
his  fine  and  took  the  fellow’s  habits  actively  in  hand.  Three  months  later  he  was 
doing  well,  and  his  Employer  was  looking  for  another  man  to  work  with  him — 
one  of  steady  habits  who  would  not  lead  him  into  temptation. 

The  former  employer  who  has  not  been  mentioned  in  a  first 
interview,  but  whose  name  comes  to  light  in  the  course  of  outside 
inquiries,  is  what  has  been  called  a  “supplementary  clue.”2  He 
is  often  a  valuable  witness. 

It  has  been  said  that  Employers  and  fellow  workmen  know  little 
about  home  conditions,  but  the  matters  about  which  they  do  know 
are  intimately  related  to  the  home,  and  their  items  of  evidence  have 
all  the  more  value  because  they  are  circumstantial  and  indirect. 
If  we  know  how  to  piece  them  together  and  weigh  them  as  against 
1  See  p.  170  on  the  order  in  which  outside  sources  should  be  visited.  2  See  p.  1 74* 

242 


EMPLOYERS  AND  OTHER  WORK  SOURCES 


other  testimony,  our  work  in  the  home  will  be  better  rounded. 
Just  as  the  teacher  who  studies  her  pupils  gives  revealing  evidence 
about  home  conditions  and  habits,  though  she  may  never  have 
entered  the  home,  so  the  Employer's  facts  and  first-hand  observa¬ 
tions  have  a  relation  to  these  same  things,  though  his  inferences 
and  opinions  may  be  of  little  value. 

In  attempting  to  gauge  the  possibilities  in  the  father  of  two  boys  (aged  eleven 
and  three)  who  was  said  to  be  neglecting  them,  a  charity  organization  society  re¬ 
ceived  the  following  estimate  from  a  naval  station:  Man  was  in  the  marine  corps  for 
fifteen  years,  was  promoted  to  sergeantcy  and  in  charge  of  a  prison  guard.  Began 
to  drink  some,  and  they  felt  he  would  be  better  in  the  Philippines.  While  there, 
saved  the  life  of  his  commanding  officer  and  received  commendation  and  a  medal. 
On  his  return  to  this  country,  was  again  given  the  post  of  sergeant  of  the  guard. 
At  this  time,  was  drinking  more  and  more  and  was  less  reliable — mixed  up  in  a 
number  of  scrapes.  At  the  end  of  enlistment  was  honorably  discharged.  Then 
went  into  the  labor  department,  where  he  held  an  important  clerkship.  Discharged 
for  being  drunk  in  working  hours.  Conduct  was  poor  but  work  was  excellent. 
Fine  fellow,  above  the  average  in  intelligence,  and  could  have  been  advanced  con¬ 
siderably  in  the  service  but  for  his  drinking  habits. 

The  same  society  was  able  to  get  a  portion  of  the  family  background  needed  in 
planning  for  an  Italian  widow  with  three  children  from  an  Employer’s  report  on  the 
work  record  of  her  deceased  husband,  who  was  a  stone  mason:  Not  like  the  ordinary 
Italian;  began  with  low  wages  but  worked  up  to  $2.75  a  day.  Got  into  debt  and 
used  to  ask  for  extra  work,  so  that  he  sometimes  earned  $19  or  $20  a  week.  If  the 
Employer  wanted  anyone  to  help  him  set  up  a  gravestone  always  asked  C,  and  he 
was  ready  and  willing.  Non-union  man,  no  benefit  society  so  far  as  known,  worked 
at  this  one  place  until  a  few  days  before  his  death.  Debts  were  contracted  first, 
it  was  thought,  owing  to  illness  of  little  boy  and  of  wife,  who  was  sick  a  good  deal. 
Then  his  brother  got  into  trouble  by  buying  on  the  installment  plan,  and  C  had  to 
help  him  out. 

A  boy  of  fourteen  complained  to  an  S.  P.  C.  C.  of  the  treatment  that  he  received 
from  his  father.  His  case  was  taken  into  court,  but,  under  questioning  by  the 
judge,  his  statements  were  contradictory.  The  boy’s  former  employer  was  then 
seen,  who  said  the  boy  had  lost  money  while  working  for  him,  and  had  been  dis¬ 
charged  for  carrying  tales  about  the  office  which  were  without  foundation — he  was 
very  untruthful,  in  fact.  No  doubt  about  his  neglect  at  home,  however,  as  his 
clothes  and  shoes  would  hardly  hold  together,  and  they  were  obliged  to  fit  him  out 
themselves.  The  young  woman  stenographer,  seen  separately,  agreed  that  the 
boy  was  untruthful,  but  added  that  his  parents  bought  him  no  clothing  whatever 
during  the  whole  winter  of  his  employment.  This  warning  as  to  the  boy’s  romanc¬ 
ing  and  the  confirmation  of  his  neglected  condition  would  both  have  been  useful  in 
preparing  the  case  for  its  first  presentation  in  court. 

The  same  S.  P.  C.  C.  was  dealing  with  a  non-support  case,  involving  four  chil- 

243 


SOCIAL  DIAGNOSIS 


dren  under  the  age  of  six.  The  proprietor  of  a  garage  reported  that  he  had  given 
work  to  the  children’s  father  at  the  request  of  a  former  employer  who  knew  and  felt 
sorry  for  the  family.  No  signs  of  liquor  during  the  eight  weeks  that  the  man  worked 
for  him,  but  he  often  failed  to  come  to  work.  Shiftless  and  lazy.  Was  warned 
that  if  he  did  not  do  the  work  properly  he  would  be  discharged.  But  for  his  care¬ 
lessness  might  have  had  the  work  indefinitely.  (This  last  statement  had  a  direct 
bearing  upon  proof  of  non-support.) 

2.  Present  Employers.  Workers  in  family  and  in  child-saving 
agencies  agree  that  inquiries  of  the  present  employer  are  difficult 
and  to  be  avoided  if  possible,  unless  the  head  of  the  establishment 
or  its  foreman  is  known  to  be  one  who  can  be  interested.  Complete 
avoidance  of  the  risk,  however,  would  work  great  hardship  to 
innocent  people. 

Upon  a  complaint  from  a  wife  with  two  children  that  her  husband  drank  and  did 
not  support  his  family,  a  letter  of  inquiry  was  written  to  the  office  by  which  the  man 
was  employed,  stating  the  wife’s  grievances.  This  brought  a  request  for  further  par¬ 
ticulars,  but  soon  after  a  second  letter  came  stating  that  the  man  had  been  dis¬ 
charged  because  they  could  not  keep  anyone  in  their  employ  who  drank.  The  dis¬ 
charge  may  have  been  hastened  by  the  inquiry,  and  the  possibility  of  some  such 
action  ought  to  make  agencies  very  careful  about  sending  letters  to  unknown  Em¬ 
ployers,  though  a  simple  request  for  the  man’s  work  record  might  have  been  harm¬ 
less  enough. 

Probation  officers  find  that  they  have  to  be  very  careful  about 
seeing  the  Employers  of  their  boys  and  girls.  With  some  firms 
the  mere  discovery  that  a  child  has  been  brought  into  court  leads 
to  immediate  discharge.  There  are  others,  however,  who  take 
more  interest  in  a  boy  on  probation  than  in  one  who  needs  no  over¬ 
sight.  Obviously,  an  important  part  of  a  probation  officer’s 
equipment  is  a  knowledge  of  the  attitude  of  the  factories  and  shops 
of  his  district  toward  their  young  people. 

In  non-support  cases  requiring  court  action  the  evidence  of 
present  employers  is  even  more  important  than  that  of  former  em¬ 
ployers,  for  the  prosecuting  agency  must  be  able  to  give  the  man’s 
exact  earnings,  the  duration  of  his  employment,  the  number  of 
times  that  he  has  been  absent  from  work,  and  the  supposed  causes 
of  absence,  as  well  as  the  occasions  and  amounts  of  wage  attach¬ 
ments  for  debt.  Often  the  man  exaggerates  the  number  and 
amount  of  these  attachments. 

An  S.  P.  C.  C.  received  a  complaint  that  a  father  was  leaving  four  children,  rang¬ 
ing  in  age  from  four  to  eleven  years,  alone  at  home  not  only  in  the  daytime  but  all 

244 


EMPLOYERS  AND  OTHER  WORK  SOURCES 

night.  The  father’s  present  employer  was  not  seen  before  the  trial,  and  the  judge 
decided  that  the  neglect  was  not  wilful,  because,  when  a  witness  testified  to  the  fact 
of  night  absences,  the  father  claimed  that  he  had  been  away  only  one  night,  when  he 
had  changed  shifts  with  another  man.  After  the  trial,  the  contradicted  witness 
obtained  a  letter  from  the  man’s  Employer  giving  thirty-six  dates  on  which  he  was 
recorded  as  having  done  night  work  during  the  last  six  months. 

The  following  are  instances  of  co-operation  with  present  em¬ 
ployers  whom  it  was  possible  to  interest  and  from  whom  useful 
information  was  had: 

A  public  department  for  the  care  of  dependent  children  had  as  its  wards  two  chil¬ 
dren  aged  eleven  and  nine  whose  mother  had  eloped  with  a  man  not  their  father, 
the  whereabouts  of  the  father  being  unknown  to  the  guardian  of  the  poor  who  com¬ 
mitted  the  children.  A  journey  the  length  of  the  state  by  the  department’s  visitor 
brought  no  trace  of  the  father,  save  a  statement  that  he  used  to  be  well  known  in  a 
certain  town.  The  police  station  of  this  town  reported  that  the  man  had  been 
favorably  known  for  years,  and  had  formerly  worked  there  for  a  barber.  This 
barber  knew  the  present  employer’s  address,  which  happened  to  be  in  the  city  in 
which  the  children's  department  had  its  headquarters.  Personally  seen,  this  Em¬ 
ployer  gave  the  man  a  good  name;  said  that  he  worked  faithfully  and  well,  had  little 
initiative,  and  drank  very  occasionally.  The  Employer  was  interested  in  the  story 
of  the  children,  offered  to  increase  the  man’s  wages  at  the  first  opportunity  and  to 
encourage  him  to  make  a  home  for  his  children.  This  last  the  father  has  not  done, 
but  he  has  paid  for  their  care  regularly  for  three  years. 

A  charity  organization  society  was  able  to  interest  a  group  of  present  employers 
in  a  family  in  which  the  chief  breadwinner  had  developed  tuberculosis.  The  Em¬ 
ployer  of  the  man  had  known  nothing  of  his  illness.  He  undertook  to  move  the 
whole  family  to  the  country  and  to  aid  in  other  ways.  The  firm  employing  the 
oldest  boy  gave  a  good  report  of  his  work  and  prospects.  The  girl’s  Employers  in¬ 
creased  her  wages  upon  hearing  of  her  father’s  illness,  but  gave  reasons  for  thinking 
that  she  would  do  better  at  other  work  in  the  long  run.  The  case  reader  who  studied 
this  record  says,  “  Its  investigation  also  seems  to  show  what  I  miss  in  many  others— 
the  possibilities  in  the  particular  work,  and  the  suggestion  (where  this  is  the  case) 
that  the  employe  might  do  another  kind  of  work  better.” 

Since  it  is  a  delicate  matter  to  establish  relations  with  present 
employers,  necessary  though  their  help  may  be  in  the  treatment  of 
certain  cases,  a  good  general  rule  is  to  seek  their  help  late  in  our 
inquiry,  when  it  must  be  sought  at  all. 

3.  Prospective  Employers.  Sometimes  a  prospective  employer 
is  so  well  known  to  a  social  agency  and  so  interested  in  its  work 
that  his  establishment  becomes  an  experiment  station  for  the  test¬ 
ing  of  unknown  capabilities,  the  training  of  handicapped  or  diffi¬ 
cult  people,  and  the  interviewing  of  unemployed  men  whose  work 

245 


SOCIAL  DIAGNOSIS 


record  can  be  secured  better  by  a  business  man  than  by  a  social 
worker.  Sometimes  a  prospective  employer  may  know  our  client 
well  already,  and  may  have  a  real  interest  in  his  welfare. 

But  usually  a  prospective  employer  should  not  be  seen.  His 
interest  is  slight,  and  the  one  fact  that  he  alone  can  bear  witness 
to  is  the  offer  of  work.  Sometimes  it  is  necessary  to  have  this 
fact.  If,  for  instance,  an  agency  dealing  with  homeless  or  non¬ 
resident  men  is  asked  to  pay  the  board  of  a  number  of  them  until 
they  can  get  their  first  wages,  the  statement  that  work  awaits 
them  must  be  verified  in  some  way,  and  it  cannot  always  be  veri¬ 
fied  without  inquiry  of  the  prospective  employer.  In  such  cases, 
the  client's  interests  must  be  safeguarded;  the  promise  of  work 
must  be  confirmed  without  telling  anything  of  the  worker's  affairs. 

IV.  METHOD 

In  addition  to  the  analysis  of  a  work  record  and  the  discussion 
of  the  social  worker's  relations  to  Employers,  past  and  present, 
certain  details  of  method  should  be  mentioned,  some  of  which 
apply  generally  and  some  only  in  accident  cases,  or  to  the  work  of 
the  foreign  day  laborer. 

1.  The  Approach.  Addresses  of  Employers  can  be  made  fuller 
and  more  accurate  by  reference  to  the  city  directory.  In  choosing 
among  a  number  of  former  employers,  those  for  whom  a  client  has 
worked  the  longest  in  recent  years  and  the  one  for  whom  he  worked 
the  longest  of  all  are  the  most  important  to  see,  though  contra¬ 
dictory  evidence  may  make  it  necessary  to  see  all  the  others.  Some¬ 
times  an  Employer  knows  our  client  in  other  ways,  as  fellow  member 
of  some  church  or  social  organization,  as  an  old  friend  of  his  family, 
etc.  These  relations  that  are  outside  of  business  should  be  noted. 

There  is  need  of  communication  with  the  Employer  direct,  in¬ 
stead  of  through  the  former  or  present  worker  or  his  family. 

An  Italian  widow  told  a  family  agency  that  her  daughter  of  seventeen  was  earn¬ 
ing  from  $5.00  to  $6.00  a  week  in  a  stocking  mill,  and  the  girl  herself  confirmed  this. 
At  the  mill  she  was  found  to  have  averaged  $8.50  a  week  for  the  last  eight  weeks. 

A  boy  of  eighteen,  who  was  believed  by  his  mother,  a  widow  with  a  consumptive 
daughter,  to  be  earning  $4.00  a  week,  and  so  was  paying  only  $3.00  into  the  home, 
was  found,  upon  inquiry,  to  be  earning  $8.00.  An  interview  with  the  boy  confirmed 
the  social  worker’s  opinion  that  the  mother  did  not  know. 

246 


EMPLOYERS  AND  OTHER  WORK  SOURCES 

Often  a  wife  does  not  know  her  husband’s  earnings,  and  her  state¬ 
ments,  made  in  good  faith,  are  not  accurate. 

From  what  has  already  been  said  it  is  evident  that  personal 
visits  to  industrial  establishments  are  far  more  fruitful  than  tele¬ 
phone  messages  or  letters.  An  appointment,  though,  to  see  the 
best  member  of  the  establishment  at  the  best  hour  for  him  should 
usually  be  secured  over  the  telephone.  Unfortunately,  letters 
are  the  only  means  of  communication  in  some  large  establish¬ 
ments  and  in  some  large  communities.  Rules  forbidding  personal 
interviews  may  possibly  be  set  aside,  however,  by  seeking  the  co¬ 
operation  of  proprietors  through  channels  that  are  particularly 
influential  with  them.  Perfunctory  responses  should  not  be  ac¬ 
cepted  as  the  only  ones  procurable  without  making  a  determined 
effort  to  win  social  interest  higher  up.  On  the  other  hand,  good 
service  can  be  had  through  letters  and  telephone  messages  when 
all  inquiries  about  work  records  in  a  large  concern  are  handled  by 
one  person,  and  the  agency  or  worker  inquiring  happens  to  have 
already  established  a  good  understanding  with  this  interested 
source.  In  industrial  establishments  employing  a  social  worker 
the  fact  should  be  known,  of  course,  and  the  approach  be  made 
through  him. 

Get  the  Employer’s  point  of  view  before  deciding  how  much 
can  safely  be  told  of  a  client’s  affairs,  though  more  of  what  he 
knows  will  be  revealed,  usually,  after  he  has  been  told  a  good  deal. 
Often  a  reference  to  the  foreman  is  the  best  result  that  can  be  had 
from  the  business  office  of  a  firm.  “  In  our  dealing  with  a  certain 
railroad,”  writes  Miss  Florence  Hutsinpillar,1  “we  invariably  get  a 
negligible  result  by  telephoning  to  the  office,  but  never  yet  have  we 
failed  to  get  information  of  value  when  we  pick  our  way  through 
the  yards  to  the  shops  where  we  can  find  the  foreman.” 

Equally  emphatic  testimony  is  at  hand  as  to  the  value  of  fore¬ 
women.  One  social  worker  believes  that  the  forewoman  of  a 
factory  has  a  rare  opportunity  to  do  constructive  social  work  for 
girls,  and  cites  instances  of  the  influence  of  certain  forewomen  who 
are  still  the  exception. 

2.  Accident  Cases.  In  cases  of  accident  coming  under  the  new 
compensation  laws,  procedure  must  be  regulated  by  the  provisions 

1  In  one  of  the  short,  unpublished  papers  referred  to  in  the  Preface. 

247 


SOCIAL  DIAGNOSIS 


of  the  state  law.  Social  case  work  in  what  used  to  be  a  most  un¬ 
satisfactory  group  of  cases  has  been  greatly  facilitated  by  these 
new  laws.  They  have  not  done  away  with  the  need  of  individual 
social  work  altogether  because  there  are  countless  adjustments  to 
be  made,  and  social  case  workers  who  have  the  detailed  facts  and 
are  seeking  no  personal  advantage  can  be  of  great  service,  more¬ 
over,  to  the  arbitration  boards  responsible  for  fixing  standards. 
A  group  of  case  records  brought  to  the  attention  of  the  writer 
illustrates  the  way  in  which  one  family  case  worker  was  able,  by 
energetic  inquiry,  to  challenge  with  success  an  unfair  ruling  of  the 
accident  insurance  companies  as  to  the  average  wage  of  longshore¬ 
men.  The  decision  of  an  arbitration  board  in  the  first  of  these 
cases  established  a  new  and  higher  standard  of  compensation. 

For  cases  not  coming  under  a  compensation  law  and  for  which  no 
lawyer  has  been  engaged,  Miss  Hutsinpillar  warns  the  social  worker 
to  distrust  his  own  legal  knowledge.  It  is  necessary  to  hear  the 
Employer’s  side  of  the  accident,  but,  in  doing  so,  to  compromise 
the  employe’s  interests  in  no  way,  and  to  commit  him  in  this  first 
interview  to  no  settlement.  “  However  pressing  the  necessity  of 
the  family,  let  the  need  be  met  in  some  other  way  until  the  evi¬ 
dence  is  fully  in  hand.  When  the  employer  assures  us  that  there 
is  no  case  but  says  that,  because  we  come  in  the  name  of  charity, 
he  will  give  the  employe’s  widow  $100,  it  is  here  that  the  long  sight, 
the  view  into  the  future,  is  much  needed.”  Miss  Hutsinpillar 
recommends  compromise  later,  however,  in  those  cases  in  which, 
after  good  legal  advice,  it  is  evident  that  no  legal  claim  can  be  estab¬ 
lished  under  existing  laws. 

3.  Foreign  Workmen.  Occupations  in  the  old  country  furnish 
clues  to  industrial  aptitudes  and  possibilities  over  here.  If  a  man 
has  been  a  skilled  basket  maker  in  Italy,  it  is  a  pity  to  let  him  con¬ 
tinue  to  sort  rags  in  New  York  or  Chicago.  Often  the  foreign 
workman  is  known  by  another  name  arbitrarily  given  to  him  by 
his  foreman  or  mates  at  the  shop,  and  it  is  necessary  to  discover 
what  this  name  is  before  he  can  be  identified  at  his  work  place. 
In  large  concerns  he  has  a  number,  and  may  have  his  number  tag 
or  metal  check  with  him  at  the  time  of  the  first  interview.  If  he 
speaks  no  English,  it  may  be  necessary  to  name  over  the  leading 
Employers  of  his  neighborhood  in  order  that  he  may  recognize  his 

248 


EMPLOYERS  AND  OTHER  WORK  SOURCES 


own  place  of  employment.  He  may  have  a  preference  for  seasonal 
work  instead  of  a  steady  job;  he  may  object  to  working  in  mid¬ 
winter,  for  instance.  If  so,  how  has  he  made  out  before  at  dull 
times  in  his  Lind  of  work,  and  how  are  his  fellow  workers  managing 
to  get  on? 

Sailors  (foreign  and  native)  are  given  discharge  papers  from  the 
boats  on  which  they  have  served,  stating,  among  other  things, 
seaman’s  name,  age,  place  of  birth,  date  of  entry  and  discharge, 
place  of  discharge,  character,  ability,  capacity  in  which  he  served, 
and  seamanship.  The  usual  entries  regarding  character,  ability, 
conduct,  and  seamanship  are  “G”  for  good  and  “V  G”  for  very 
good;  the  Cunard  Line  uses  only  “G.”  “D  R”  (decline  to  re¬ 
port)  is  used  when  a  record  is  unsatisfactory.  Discharge  cer¬ 
tificates  containing  anything  less  than  “V  G”  (or  “G”  from  the 
Cunard  Line)  have  a  way  of  getting  lost.  Inability  to  produce  a 
certificate  may  be  due  to  another  cause,  however,  for  in  the  Amer¬ 
ican  service,  especially  the  coastwise  service,  the  law  requiring  the 
issuance  of  these  certificates  is  very  slackly  enforced;  in  the  Eng¬ 
lish  service  it  is  strictly  enforced. 

The  work  record  of  a  day  laborer  is  more  difficult,  because  he 
may  work  for  contractors  whose  operations  are  now  in  one  place 
and  now  in  another.  Every  day  laborer  knows  where  he  was  last 
paid  and  by  whom,  however,  and  it  is  possible,  as  Miss  Sears  points 
out,1  to  get  his  Employer’s  name  in  this  way.  The  Italian  bank 
may  be  mentioned,  in  passing,  as  a  place  that  is  often  the  employ¬ 
ment  agency  for  Italians,  and  often  closely  related  to  the  padrone. 

In  the  family  of  an  Italian  day  laborer  which  applied  to  a  charity  organization 
society,  the  woman  was  sickly,  there  were  four  children  under  twelve,  the  man  came 
and  went  as  he  pleased,  and  seldom  supported  his  family.  Upon  one  of  his  periodic 
returns  he  claimed  to  have  earned  only  $60  in  six  months  over  and  above  board  and 
travelling  expenses  to  and  from  a  small  place  628  miles  away  in  which  he  had  done 
pick  and  shovel  work  on  the  railroad.  The  local  office  of  the  railroad  that  employed 
him  provided  the  society  with  the  name  and  address  of  the  construction  depart¬ 
ment  chief  in  the  city  nearest  to  the  small  place  where  he  claimed  to  have  worked. 
A  night  letter  dispatch  to  the  charity  organization  society  in  that  city  secured  the 
interest  of  this  construction  department.  The  dispatch  had  asked  length  of  time 
working,  pay,  cost  of  board,  reason  for  leaving,  whether  he  worked  full  time,  and 
whether  cold  weather  had  interfered  with  his  work.  All  of  these  points  were  cov¬ 
ered  in  the  answer,  which  showed  that  the  man  had  been  earning  enough,  over  and 

1  The  Charity  Visitor,  p.  30. 

249 


SOCIAL  DIAGNOSIS 


above  his  expenses,  to  have  sent  money  home  regularly,  and  that  he  left  of  his  own 
accord. 

V.  MISCELLANEOUS  WORK  SOURCES 

The  miscellaneous  work  sources  consulted  in  the  three  cities 
studied  were  trade  unions,  fellow  workmen,  welfare  managers, 
store  detectives,  employment  offices,  and,  in  one  case,  the  super¬ 
intendent  of  a  school  for  telephone  operators.  Store  detectives 
appear  in  the  records  of  adult  probation  departments  only.  Em¬ 
ployment  offices,  as  now  organized,  are  of  little  value  in  any  search 
for  detailed  knowledge  of  a  worker’s  possibilities. 

Unions  and  fellow  workmen  are  the  most  important  members  of 
this  miscellaneous  group,  though  neither  seems  to  have  been  used 
very  frequently.  One  reason,  perhaps,  for  the  infrequency  of  con¬ 
sultations  with  unions  is  the  difficulty  of  discovering  where  and 
when  the  union  secretary  may  be  seen. 

In  one  of  the  cases  studied,  a  bricklayer’s  union  helped  a  child-saving  agency  to 
discover  a  deserting  father;  in  another  a  Russian  cigar  maker  who  was  incurably 
ill  was  given  complete  support  through  union  sick  benefits  and  through  special 
subscriptions  from  union  members;  in  another  case,  also  that  of  a  cigar  maker,  the 
man  was  not  a  union  member,  but  was  suffering  from  a  disfiguring  and  progressive 
skin  disease,  and  the  cigar  makers’  union  raised  $60  which  it  turned  over  to  a  hos¬ 
pital  social  service  department  to  be  spent  for  him,  also  offering  to  be  responsible 
for  his  funeral  expenses.  In  this  same  hospital  social  service  department  was  found 
the  record  of  a  man  who  had  been  expelled  from  a  trade  union  because  he  had  ac¬ 
cused  its  officers  of  dishonesty.  Later  it  came  out  that,  at  the  time,  he  had  had 
the  morphine  habit.  After  the  hospital  had  practically  cured  him  of  it,  his  union 
agreed  to  reinstate  him  if  the  hospital  doctor  would  state  in  writing  that  the  man’s 
inability  to  tell  the  truth  had  been  due  to  the  habit.  This  the  doctor  was  able  to  do. 

Fellow  workmen  are  especially  generous  in  cases  of  sickness, 
either  the  sickness  of  their  shop  mate  or  of  one  of  his  family.  A 
visit  to  the  shop  of  a  sick  breadwinner  often  brings  out  the  fact 
that  “the  boys  in  the  shop”  have  taken  up  a  subscription  for  the 
man.  The  one  who  has  this  subscription  list,  as  Miss  Hutsin- 
pillar  notes,  is  a  valuable  source  of  suggestion  and  co-operation. 
He  knows  the  sick  man  and  has  a  warm  personal  interest  in  his 
affairs;  the  social  worker,  on  the  other  hand,  knows  more  than  he 
about  the  medical  and  social  resources  of  the  community  and  how 
to  use  them. 

In  preparing  the  questionnaire  on  desertion  in  Part  III  the 

250 


EMPLOYERS  AND  OTHER  WORK  SOURCES 

writer  received  from  Mr.  C.  C.  Carstens,  of  the  Massachusetts 
Society  for  the  Prevention  of  Cruelty  to  Children,  the  important 
suggestion  that  deserters  rarely  cut  themselves  off  from  all  com¬ 
munication  with  their  former  surroundings,  and  that  this  communi¬ 
cation  is  often  through  “cronies”  in  their  former  shop  or  former 
neighborhood.  Appeal  to  these  friends  is  more  successfully  made 
for  the  children  than  for  the  wife.  If  she  has  lost  her  hold,  the 
man  is  still  eager  for  news  of  his  children,  and  even  when  this 
interest  does  not  bring  him  back,  it  leads  him  to  write  to  mates 
who  can  send  news  of  them. 

At  the  beginning  of  this  chapter  it  was  said  that  the  material 
gathered  for  it  seemed  to  show  less  constructive  relations  on  the 
part  of  social  workers  to  Employers  than  to  physicians  or  teachers. 
As  case  workers  realize  more  fully  the  need  of  making  their  case 
work  better  by  linking  it  with  a  knowledge  of  mass  problems,  and 
as  they  see  that  one  bridge  between  the  two  is  supplied,  in  the  field 
of  industry,  by  an  intimate  knowledge  of  conditions  in  the  estab¬ 
lishments  that  they  themselves  visit,  their  work  will  broaden.  It 
will  become  more  intensive  and  more  inclusive— more  intensive 
as  they  seek  the  precise  items  that  show  the  relation  of  their  client 
to  the  particular  bad  condition  discovered,  and  more  inclusive 
as  they  ask  advice  and  co-operation  from  those  who  are  study¬ 
ing  conditions  of  this  type.  This  co-operation  would  mean  the 
substitution  of  a  developing  program  for  a  static  one.  The  use 
of  Employers  to  get  and  record  a  few  routine  facts  about 
wages  and  habits,  or  to  secure  for  our  clients  an  occasional  contri¬ 
bution  or  an  occasional  job,  is  surely  a  static  program  in  a  field 
which  presents  infinite  possibilities  of  usefulness  in  return  for 
greater  discrimination  and  deeper  insight.1 

1  A  critic  of  these  pages  writes,  “  If  this  point  of  view  were  in  the  mind  of  the  case 
worker  in  every  interview  with  an  employer,  it  would  mean  the  accumulation  of 
exceedingly  valuable  information  for  the  social  agency  with  which  the  worker  was 
associated.  The  information  procured  would  be  not  merely  a  contribution  to  the 
study  of  mass  problems,  but  would  constitute  material  for  constructive  work  in 
individual  cases.  This  suggests  the  possibility  of  indexing  interviews  with  em¬ 
ployers  in  a  file,  referring  back  to  the  original  case  record  entries.  I  hesitate  to  make 
this  suggestion,  since  it  would  appear  to  increase  the  amount  of  clerical  work,  but 
it  would  surely  be  of  value  to  the  case  worker  to  be  able  to  refer  quickly  to  former 
interviews  held  by  other  case  workers  with  an  employer  unknown  to  him  and  to 
whom  he  may  now  be  turning  with  a  specific  problem.” 

251 


SOCIAL  DIAGNOSIS 


*1>  ^  V5 


SUMMARY  OF  THIS  CHAPTER 

1.  The  reasons  for  studying  a  client’s  work  record  in  detail  are  (i)  the  great 
variation  possible  in  degrees  of  employment,  unemployment,  and  employability; 
(2)  the  lack  of  standardization  of  wages  and  work  conditions  in  the  same  processes 
of  the  same  industry;  (3)  the  possibilities  of  advancement  for  a  client;  (4)  the 
possibilities  of  reinstatement. 

2.  A  case  worker  who  studies  the  work  record  of  a  client  with  the  aid  of  the  out¬ 
line  given  in  this  chapter  (p.  239)  should  interpret’the  facts  thus  secured  in  the  light 
of  the  other  facts  of  his  client’s  history — facts  of  health,  training,  family  background, 
etc.  A  work  record  has  little  significance  in  case  work  without  this  context. 

3.  Employers  are  often  quoted  in  social  records  as  authorities  upon  matters  con¬ 
cerning  which  their  knowledge  is  hearsay,  such  as  home  conditions,  character  of  an 
employe’s  wife,  etc.  Other  drawbacks  of  Employers  as  witnesses  are  that  their 
statement  of  wages  earned  may  be  the  maximum  of  possible  earnings  unless  the 
hours  actually  worked  are  asked  for;  that  their  written  letters  of  recommendation 
"to  whom  it  may  concern’’  may  be  valueless;  and  that  they  may  sometimes  be 
tempted  to  conceal  the  truth  about  a  particularly  useful  workman. 

4.  Former  employers  can  be  consulted  with  far  greater  freedom  than  present 
employers,  and  the  information  that  they  are  able  to  supply  often  (though  not  in¬ 
variably)  makes  communication  with  the  latter  unnecessary.  The  most  important 
former  employer  witnesses  are  those  for  whom  a  client  has  worked  the  longest  in 
recent  years. 

5.  In  certain  cases  the  evidence  of  present  employers  is  essential.  In  non¬ 
support  cases,  for  example,  it  is  necessary  to  know  exact  earnings,  duration  of  em¬ 
ployment,  number  of  times  absent  from  work,  supposed  causes  of  absence,  and 
number  and  amounts  of  wage  attachments  for  debt. 

6.  As  a  rule,  though  ther^e  are  exceptions,  prospective  employers  should  not  be 
interviewed. 

7.  Personal  visits  to  industrial  establishments  and  interviews  with  foremen 
especially  are  far  more  fruitful  than  communications  by  letter,  though  some  firms 
refuse  to  give  information  in  any  other  way  than  by  letter. 

8.  In  accident  cases  not  coming  under  the  compensation  law  care  is  necessary  to 
avoid  compromising  the  employe’s  interests. 

9.  The  work  record  of  a  day  laborer  working  for  contractors,  especially  when  the 
laborer  is  foreign,  presents  certain  difficulties,  but  every  worker  knows  where  he 
was  last  paid  and  by  whom. 

■—TO.  Aside  from  Employers,  the  most  important  work  sources  are  trade  unions 
and  fellow  workmen. 

11.  An  intimate  knowledge  of  work  conditions  in  the  industrial  establishments 
visited  by  the  case  worker  will  make  him  a  better  diagnostician  and  also  a  better 
co-operator  with  those  who  seek  to  improve  conditions  of  industry. 


252 


CHAPTER  XIII 
DOCUMENTARY  SOURCES 


ASTUDENT  of  social  work  would  find  it  an  illuminating  exer¬ 
cise  to  make  a  list  of  the  numerous  places  in  which  some  one 
L  or  more  of  the  facts  of  his  own  life  are  on  record,  and  then 
examine  the  entries,  in  so  far  as  this  is  possible.  He  would  find  that 
the  most  personal  of  these,  such  as  the  date  of  his  birth,  his  stand¬ 
ing  in  school,  his  inheritance,  purchase,  or  transfer  of  certain  forms 
of  property,  his  marriage,  his  fatherhood,  the  deaths  of  those  dear 
to  him,  are  matters  of  public  record;  and  that  in  many  professional 
and  business  records  besides — those  of  physicians,  dentists,  insur¬ 
ance  companies,  banks,  and  retail  dealers,  to  name  only  a  few — 
some  of  the  most  intimate  facts  about  him  are  neatly  indexed  and 
filed  away.  In  addition  to  the  witness  of  these  unprinted  docu¬ 
ments,  he  would  find  himself  recorded,  perhaps,  in  city  and  tele¬ 
phone  directories,  in  professional  directories  and  periodicals,  in 
church  year  books,  in  the  advertising  and  news  columns  of  the 
daily  papers,  and  in  the  membership  lists  of  professional,  graduate, 
political,  benefit,  and  social  organizations.  However  uneventful 
his  life,  however  retiring  his  disposition,  he  would  discover  that  he 
was  already  very  much  on  record;  he  is  destined  to  be  still  more 


so,  indeed,  as  community  life  becomes  more  highly  organized. 

In  the  course  of  his  inquiry,  he  would  also  find  that  the  docu¬ 
ments  in  which  his  name  appears  fall  into  two  large  classes — into 
documents  of  original  entry  and  those  that  are  copies  or  in  some 
other  way  derivative  from  the  originals.  The  documents  of  origi¬ 
nal  entry  would  not  always  be  accurate,  perhaps,  but  the  copies 
could  not  possibly  be  so  unless  their  originals  recorded  the  truth 
about  him.  In  fact,  everything  that  he  had  learned,  in  the  course 
of  his  work,  about  the  superiority  of  first-hand  information  would 
be  found  to  be  applicable  in  his  scrutiny  of  these  documents.  He 
might  have  been  in  the  habit  of  regarding  himself  as  the  best 
possible  source  of  information  about  everything  that  concerned 


253 


SOCIAL  DIAGNOSIS 


him  individually.  In  that  case,  he  would  soon  find  that  he  was 
mistaken;  that  the  record  made  at  the  time  corrects  not  only 
inaccuracies  but  aberrations  of  memory.  If  the  experiment  is 
tried  with  any  degree  of  thoroughness,  he  will  be  less  afflicted 
thereafter  by  what  one  case  worker  calls  “clue  blindness/’  and  will 
have  learned  to  consult  documents  oftener  in  his  daily  work,  despite 
a  prejudice  against  them  which  is  common  among  social  workers. 

This  prejudice  against  the  written  word  is  due,  probably,  to  the 
too  great  confidence  often  reposed  in  it  by  the  case  worker’s  clients, 
with  many  of  whom  anything  that  is  written  and  signed  is  regarded 
as  satisfactory  proof.  The  “testimonials”  that  are  proffered  by 
clients,  and  the  blank  forms  that  are  so  cheerfully  filled  out  by 
their  “references,”  are  often  worthless  because  they  have  been 
prepared,  however  honestly,  for  the  occasion  and  with  conscious 
or  unconscious  bias.  Then  too,  even  where  the  document  tells 
truthfully  all  that  it  purports  to  tell,  and  even  where  it  is  not  prof¬ 
fered  by  the  one  most  concerned  but  reaches  the  social  worker  in 
some  other  way,  it  often  conveys  only  a  small  part  of  what  is 
needed  and  of  what  its  writer  could  reveal  if  seen  face  to  face. 

There  would  seem  to  be  a  distinction,  then,  between  the  docu¬ 
ments  that  record  in  a  colorless  way  events,  dates,  and  places,  and 
those  that  sum  up  more  or  less  subjective  experiences  and  impres¬ 
sions.  The  social  worker  is  fortunate  in  that,  dealing  for  the  most 
part  with  contemporary  data,  he  can  seek  the  source  behind  the 
document  in  the  many  cases  in  which  the  document  does  not  suffice, 
and  the  document  itself  in  those  many  other  cases  in  which  the 
memory  of  an  individual  cannot  be  depended  upon.  Generally 
speaking,  the  individual’s  testimony  is  least  satisfactory  in  regard 
to  those  matters  of  time,  place,  amount,  and  procedure  in  which 
accuracy  is  vital;  and  the  document  is  least  satisfactory  in  those 
matters  of  personal  experience  and  human  relation  in  which  the 
motives  and  capacity  of  the*  witness,  the  atmosphere  and  spirit 
of  his  statement,  are  all  important. 

•  For  objective  matters  of  fact,  the  more  impersonal  our  sources 
the  better.  It  is  foolish  to  listen  to  the  conjectures  and  opinions 
of  a  dozen  witnesses,  none  of  them  wholly  disinterested,  about  a 
matter  that  was  recorded  under  circumstances  that  precluded  all 
thought  of  the  point  now  at  issue,  when  this  colorless,  disinterested, 

254 


DOCUMENTARY  SOURCES 


and,  perhaps,  accurate  record  is  accessible.  Disinterestedness  and 
accuracy  are  not  synonymous,  of  course;  records  are  to  be  handled 
critically,  as  all  our  evidence  must  be;  but  it  marks  a  tendency  to 
consult  the  wrong  sources  for  objective  matters  that  the  social 
agencies  in  two  of  the  three  cities  studied  were  found  to  be  consult¬ 
ing  original  documents  in  the  rarest  instances.  Out  of  1,600  case 
records  examined  in  these  two  cities,  there  was  found  not  a  single 
instance  of  the  consultation  of  a  marriage  record;  birth  records 
were  examined  14  times  (11  of  these  records  were  foreign);  bap¬ 
tismal  records,  6  times;  property  records,  5  times;  court  records, 
29  times;  immigration  records,  6  times;  passports,  3  times;  and 
miscellaneous  records,  1 1  times.  In  the  other  city  (see  analysis  of 
sources  in  Appendix  II,  Table  B)  the  value  of  records  had  been 
discovered.  Out  of  1,200  cases  examined,  the  consultations  of 
records  were  as  follows:  Marriage,  143;  divorce  and  legal  separa¬ 
tion,  1 6;  birth,  139;  baptism,  36;  property,  36;  death,  28;  con¬ 
tagious  disease,  19;  insurance,  15;  guardianships;  insanity  com¬ 
mitments,  30;  court  records  not  otherwise  counted,  21;  immigra¬ 
tion  records,  4;  miscellaneous  records,  7.  An  examination  of  a 
number  of  other  cases  in  this  same  city  in  the  course  of  the  case 
reading  for  this  book  shows  a  firmness  of  texture  in  treatment  that 
can  be  traced  directly  to  this  habit  of  consulting  Documentary 
Sources.  The  habit  should  be  formed  wherever  such  records  are 
available,  and,  wherever  they  are  not,  social  workers  should  be  as 
much  interested  as  the  bar  and  the  medical  associations  in  securing 
better  public  records. 

It  may  be  noted,  in  passing,  that  here  also  is  an  opportunity  to 
relieve  the  overburdened  case  worker.  The  work  of  consulting 
records  either  in  person  or  by  correspondence  can  be  delegated 
without  the  loss  of  efficiency  that  often  results  when  other  impor¬ 
tant  parts  of  social  diagnosis  and  treatment  are  delegated.  In  an 
agency  employing  a  number  of  workers,  some  one  of  these  can 
master  the  details  of  consulting  records  near  by  and  at  a  distance, 
and  can  do  all  of  this  work  that  needs  to  be  done. 

K  PRESENT  USE  OF  DOCUMENTS 
« 

As  brought  to  light  in  our  case  reading,  the  present  social  work 
uses  of  documents  are  fairly  obvious  ones.  They  fall,  roughly, 

255 


SOCIAL  DIAGNOSIS 


under  a  search  for  facts  about  birth,  death,  marriage,  divorce, 
whereabouts,  property,  immigration,  and  conduct.  The  docu¬ 
mentary  evidence  of  social  agency  records  will  be  considered 
separately  in  Chapter  XVI,  Social  Agencies  as  Sources. 

1.  Birth  and  Death  Records.  Reasons  for  discovering  the  exact 
age  of  a  child — not  merely  the  year  and  the  month  but  the  day  of 
the  month — have  already  been  given.1  The  documents  in  the 
family’s  own  possession  that  are  used  to  establish  births  are  family 
Bibles,  certificates  of  baptism,  and  passports.  The  original  records 
are  usually  those  of  churches  made  at  the  time  of  baptism,  or  of 
doctors  and  midwives,  who  are  required  by  law,  in  many  places, 
to  report  all  births  to  the  public  department  of  health  or,  in  smaller 
places,  to  the  town  clerk  or  the  health  officer.2  The  church  register 
of  baptisms  is,  in  some  countries,  the  sole  source.  When  any 
question  arises  as  to  a  child’s  age,  it  is  always  well  to  try  to  procure 
a  transcript  of  the  birth  record.3 

Some  states  have  established  state  archives,  in  which  the  birth 
records  of  the  entire  state  are  assembled.  These  are  not  the  original 
documents,  but  direct  transcripts  from  them,  subject  only  to  the 
kinds  of  error  due  to  copying. 

An  S.  P.  C.  C.  records  several  cases  of  moral  danger  to  girls  in  which,  before  any 
steps  could  be  taken  or  any  extended  inquiry  made,  it  was  necessary  to  consult 
the  public  records  and  discover  whether  these  girls  were  over  seventeen  (as  they 
claimed  to  be),  or  seventeen  or  under.  Because  of  certain  legal  restrictions,  a  plan 
of  treatment  could  be  much  more  effectively  carried  out  in  the  latter  case  than  in 
the  former. 

A  public  department  for  the  care  of  children  notes  that,  in  one  case,  where  the 
father  and  mother  were  named  John  and  Mary  and  their  last  name  was  a  common 
one,  it  would  have  been  impossible  to  identify  the  birth  records  of  their  children 


1  See  p.  154. 

2  A  social  worker  who  examines  applications  for  work  certificates  in  a  large  city 
instructs  her  assistants  to  address  inquiries  about  birth  certificates  in  any  American 
city  to  the  registrar  of  births.  Even,  where  there  is  no  official  so  named  the  letter 
is  delivered  and  answered. 

3  Birth  certificates  in  New  York  City  cover  the  following  items: 


Name  of  child 
Sex 
Color 

Date  of  birth 
Place  of  birth;  that 
street  and  number 


Father’s  name 
Father’s  birthplace 
Father’s  age 
Father’s  occupation 
is,  Mother's  name  and  maiden 
name 

Mother’s  residence 

256 


Mother’s  birthplace 
Mother’s  age 
Number  of  previous  chil¬ 
dren 

How  many  now  living  in 
all 


DOCUMENTARY  SOURCES 


without  the  maiden  name  of  the  mother.  Marriage  records  seldom  can  be  identi¬ 
fied  without  this  item. 

The  four  kinds  of  documentary  evidence  named  in  New  York’s 
child  labor  law  are  (i)  certificates  of  birth,1  (2)  certificates  of  grad¬ 
uation  accompanied  by  evidence  from  school  that  the  child  is 
fourteen  years  old,  (3)  passports  or  baptismal  certificates,  (4) 
“other  documentary  evidence”  satisfactory  to  the  board  of  health. 
Until  the  board  is  satisfied  that  no  certificate  of  birth  can  be 
obtained,  no  other  evidence  is  accepted. 

The  “other  documentary  evidence”  that  has  proved  acceptable 
to  the  board  includes  (1)  the  manifest  sheet  at  the  immigration 
station,  (2)  father’s  naturalization  papers,  (3)  insurance  policies, 
(4)  Bible  records,  (5)  Bar  Mizvah  certificates,  (6)  circumcision 
records,  (7)  confirmation  records,  (8)  court  records,  (9)  hospital 
records,  (10)  children’s  institution  records,  and  (11)  other  social 
agency  records. 

■The  board  finds  that  the  record  at  Ellis  Island  is  more  likely  to 
understate  than  overstate  a  child’s  age,  because  parents  often  seek 
to  avoid  paying  fare  for  their  children.  Bible  records  are  good  if 
the  Bible  is  not  too  new  and  the  entries  are  in  ink.  One  family 
Bible  presented  as  evidence  of  a  birth  supposed  to  have  been 
recorded  in  1895  was  found  to  have  been  published  in  1904.  The 
Bar  Mizvah  certificate  testifies  to  the  performance  of  a  Jewish 
ceremony  which  usually  takes  place  when  a  boy  is  thirteen,  but 
may  take  place,  if  his  father  has  died,  at  twelve.  Circumcision 
records  (the  ceremony  is  usually  on  the  eighth  day  after  birth)  are 
good  evidence,  but  difficult  to  obtain  when,  as  often  happens,  they 
are  in  the  custody  of  elderly  men  unwilling  to  make  an  affidavit. 
Confirmation  and  first  communion  records  are  regarded  as  good 
evidence;  so  are  hospital  records  when  the  treatment  was  given 
more  than  two  years  before  the  application  for  an  employment 
certificate.  Day  nursery  records  are  better  than  those  of  other  social 
agencies,  because  they  were  made  when  the  child  was  very  young. 

Among  the  kinds  of  documentary  evidence  of  age  that  the 
board  of  health  has  found  unsatisfactory  are  statements  of  private 
physicians,  personal  affidavits,  and  school  records.  Some  parents 

1  See  How  to  Obtain  Foreign  Birth  Certificates,  a  leaflet  printed  by  the  New 
York  Child  Labor  Committee. 

17 


257 


SOCIAL  DIAGNOSIS 


overstate  their  children's  ages  to  get  them  into  school  before  they 
are  of  school  age.  In  general,  the  board  regards  records  made  less 
than  two  years  before  the  application  for  work  certificates  as 
likely  to  be  untrustworthy.  Where  facts  were  recorded  a  number 
of  years  before  the  work  certificate  question  was  a  pressing  one,  this 
particular  incentive  to  misrepresentation  probably  was  not  present. 

Death  records  present  few  difficulties,  and  are  usually  accepted 
as  proof  that  the  death  actually  occurred  on  the  date  recorded. 
Entries  of  death  as  filed  at  the  board  of  health  and  in  hospital 
records  often  give  clues  to  other  needed  evidence  besides  proof  of 
death.1 

2.  Marriage  and  Divorce  Records.  Marriage  records  vary  in 
form  and  in  place  of  custody  with  the  marriage  laws  of  different 
states.  In  some,  a  religious  ceremony  is  the  only  legal  one;  in 
others,  civil  marriage  and  even  common-law  marriage,  or  public 
acknowledgment  of  the  relation,  constitute  a  legal  bond.  Civil 
records  of  marriage  licenses  and  church  records  are  the  chief 
sources;  both  are  better  than  marriage  certificates.  The  existence 
of  a  record  is  not  conclusive  proof  of  the  legality  of  a  marriage. 
It  may  have  been  solemnized  when  one  or  the  other  was  married 
already,  or  when  one  was  of  an  age  which  requires  the  consent  of 
parent  or  guardian.  If  the  marriage  took  place  in  another 
state  from  the  one  in  which  both  parties  to  it  resided,  a  search  for 
the  reason  sometimes  reveals  serious  irregularities. 

A  young  couple  with  two  small  children  were  under  the  care  of  a  charity  organi¬ 
zation  society  for  some  months  before  the  disappearance  of  the  man,  who  had  com¬ 
mitted  a  felony.  After  his  disappearance  the  woman  acknowledged  that  they  were 

1  New  York  City  death  certificates  call  for  the  following  items: 

Place  of  death;  that  is,  borough  and 
street  number 
Character  of  premises 
Full  name 
Color  or  race 

Single,  married,  or  widowed 
Date  of  birth 
Age 

Occupation 
Birthplace 

If  foreign  born,  how  long  in  the  United 
States  and  how  long  in  New  York  City 
Name  of  father 

Birthplace  of  father;  that  is,  state  and 
country 


Maiden  name  of  mother 
Birthplace  of  mother 
Former  or  usual  residence  (This  is  given 
in  cases  where  deaths  occur  in  hos¬ 
pitals  or  institutions  and  when  the 
deaths  are  those  of  non-residents  or 
recent  residents) 

Cause  of  death 
Physician’s  name  and  address 
Where  was  the  disease  contracted  if 
not  at  the  place  of  death 
Place  and  date  of  burial 
Undertaker’s  name  and  address 


258 


DOCUMENTARY  SOURCES 


not  married.  A  much  earlier  search  for  evidence  of  marriage  would  have  saved 
the  woman,  who  was  apparently  far  better  than  the  man,  from  months  of  abuse  and 
humiliation. 

A  legal  aid  society  bestirred  itself,  in  one  of  the  cases  reviewed,  to  procure  and 
actually  obtained  a  separate  support  order  for  a  woman  from  her  alleged  husband, 
who  drank  and  neglected  her.  It  came  out  later  that  the  woman’s  record  was  even 
worse  than  the  man’s  and  that  there  had  been  no  marriage. 

One  woman,  whose  affection  for  the  man  whom  she  called  her  husband  seemed 
slight,  refused  to  swear  out  a  warrant  for  non-support.  The  hospital  social  worker 
interested  in  her  affairs  discovered  that  the  pair  were  not  married. 

In  one  case,  where  a  marriage  record  was  not  at  first  discovered,  the  man  had 
been  married,  as  the  public  department  interested  in  his  children  found  out  later, 
under  an  assumed  name.  He  had  deserted  from  the  Navy,  and  so  wished  to  conceal 
his  identity. 

Proof  of  legal  marriage  is  very  necessary  in  family  desertion  and 
in  separation  and  non-support  cases.  It  is  also  a  protection  to 
children  whose  legitimacy  is  in  question. 

A  child-saving  agency  had  moral  but  not  legal  proof  that  a  child  was  exposed  to 
moral  danger  in  the  custody  of  its  mother.  A  search  for  her  marriage  record  led 
to  her  acknowledgment  later  that  she  was  not  married  and  to  the  commitment  of 
the  child. 

In  the  same  agency  a  search  of  both  birth  and  marriage  records  established  the 
paternity  of  a  child  and  reunited  its  parents.  The  father,  who  had  been  at  sea  at 
the  time  of  its  birth  and  for  some  months  before,  had  been  told,  probably  with 
malicious  intent,  that  it  was  born  five  months  after  his  marriage.  The  public 
records  proved  that  the  child  had  been  born  eleven  months  after  the  marriage. 

In  looking  up  marriage  records  it  must  be  borne  in  mind  that 
there  are  various  reasons  for  minor  differences  of  date.  The  date 
of  the  public  record  may  be  that  of  the  issuing  of  the  license, 
whereas  the  license  may  have  been  held  a  good  while  and  the  date 
of  the  marriage  (the  date  given  by  the  client)  would  thus  be  a 
later  one.  Sometimes  a  marriage  has  taken  place,  but  there  has 
been  tardiness  in  making  the  return  to  the  bureau  of  licenses,  or  no 
return  whatever  has  been  made. 

Divorce  records  may  sometimes  have  to  be  consulted  to  establish 
the  rights  of  children  or  the  legality  of  a  later  union. 

A  case  committee  was  asked  to  suggest  the  best  thing  to  do  for  a  couple  living 
together  as  man  and  wife.  There  were  two  children — one  by  a  former  union  of  the 
woman’s  to  a  man  who  had  left  her  years  before,  and  to  whom  she  claimed  to  have 
been  married.  Some  of  her  advisers,  feeling  that  there  was  real  affection  in  the 
present  home,  offered  the  aid  of  a  lawyer  to  obtain  the  annulment  of  the  woman’s 

259 


SOCIAL  DIAGNOSIS 


marriage  on  the  ground  of  her  husband’s  long  continued  absence,  and  thus  make  it 
possible  for  her  to  marry.  But  the  wife  took  no  steps  to  this  end,  and  later  it  came 
to  light  that  there  had  been  a  third  and  earlier  relation  to  a  man  who  must  have 
been  married  to  her  because  he  had  obtained  a  divorce.  These  facts  raised  two 
questions  in  the  minds  of  the  committee,  who  decided  that  no  suggestions  as  to 
treatment  could  be  made  until  they  had  been  answered.  First,  had  the  woman 
been  married  to  the  father  of  the  older  of  the  two  children?  The  record  had  not 
been  looked  up.  Second,  what  were  the  circumstances  of  the  still  earlier  marriage 
and  divorce?  The  record  had  not  been  examined. 

3.  Records  Indicating  Whereabouts.  Frequently  it  is  difficult 
to  discover  the  present  or  previous  whereabouts  of  a  relative  of  a 
client,  or  some  other  interested  person.  Directories  are  the  first 
resource  in  such  cases,  and  their  use  is  discussed  in  some  detail 
on  p.  265,  but  a  number  of  unpublished  lists  and  records  have  also 
been  found  to  be  useful.  Besides  formal  records  of  birth,  death, 
marriage,  property,  etc.,  which  often  reveal  the  whereabouts  of 
someone  other  than  the  principals,  illustrations  are  at  hand  of 
reference  to  voting  lists,  enlistment  records,  police  precinct  books, 
receipts  of  foreign  drafts,  and  cemetery  records. 

The  social  service  department  of  a  dispensary  failed  to  find  a  patient  at  the  ad¬ 
dress  given  when  he  did  not  return  for  much  needed  treatment.  The  voting  list 
of  the  district  was  consulted,  and  this  showed  his  transfer  to  another  voting  dis¬ 
trict.  In  this  second  district  he  had  not  yet  registered,  but  it  was  suggested  at  the 
registration  office  that  the  ward  boss  be  seen.  Through  him  the  man’s  address  was 
discovered. 

A  family  case  worker  reports  that,  when  the  city  directory  fails  to  make  an  ap¬ 
proximate  address  more  definite,  she  usually  consults  the  voting  list  before  attempt¬ 
ing  a  house  to  house  inquiry. 

Voting  lists  are  also  consulted  by  an  S.  P.  C.  C.  to  discover  the  whereabouts  of 
fathers  who  have  left  their  families  but  are  believed  to  be  in  the  city.  This  same 
society  often  consults  the  Army  and  Navy  enlistment  office  records  in  seeking  a  de¬ 
serter  who  is  young  enough  and  strong  enough  to  have  been  enlisted.  He  often 
gives  an  assumed  name  at  the  recruiting  station,  but  can  sometimes  be  traced 
by  his  description  and  by  the  date  of  enlistment.  He  claims  to  be  single,  of  course. 
In  one  such  case,  where  the  man  had* enlisted  in  the  Navy,  the  society  got  a  prompt 
and  satisfactory  reply  to  the  following  letter:  “We  learn  from  the  enlistment  office 
in  this  city  that  you  enlisted  August  10  after  taking  an  oath  that  you  were  a  single 
man  and,  therefore,  can  be  arrested  for  perjury.  You  left  your  wife  and  two  chil¬ 
dren  under  two  years  old  without  support.  We  learn  that  you  will  receive  your  first 
pay  October  10.  Now  if  you  will  write  your  wife  saying  you  will  send  her  a  large 
portion  of  this  money,  so  far  as  we  are  concerned  there  will  be  no  further  action 
taken.” 


260 


DOCUMENTARY  SOURCES 


A  postal  card  from  Fort  Slocum  written  by  a  runaway  boy  to  his  father  said 
nothing  of  enlistment  but  furnished  a  clue  which  was  followed  up  by  a  letter  to  the 
commandant  of  the  fort.  This  brought  the  reply  that  the  boy  had  enlisted  and 
given  his  age  as  twenty-one  years  and  two  months.  His  real  age  was  seventeen. 

Information  about  the  character  of  a  particular  neighborhood  or  house  or  store 
can  sometimes  be  had  at  the  police  station  in  that  district,  where  the  police  precinct 
book  may  reveal  police  relations  with  the  place  in  question.  This  form  of  inquiry  has 
been  found  especially  useful  just  before  helping  to  move  a  family  into  new  quarters. 

Some  large  police  departments  have  a  lost  and  found  bureau  which  consults  am¬ 
bulance  and  hospital  records  on  request  in  cases  of  sudden  disappearance. 

A  young  Armenian  was  returned  to  Constantinople  by  an  agency  for  the  care  of 
homeless  men.  There  was  some  doubt  as  to  whether  he  would  go  to  his  destination, 
but  a  foreign  draft  for  his  use  in  getting  established  there  was  found  to  have  been 
paid  and  duly  receipted  for,  which  established  his  whereabouts. 

After  a  factory  fire  in  which  many  foreign  girls  lost  their  lives,  the  records  of 
banks  in  the  foreign  quarter  revealed  the  addresses  of  the  families  of  some  of  those 
who  had  been  sending  money  home  through  the  banks.  The  records  of  foreign 
drafts  at  the  post  office  were  also  consulted. 

A  social  worker  who  has  been  making  some  eugenic  studies  finds  cemetery  records 
of  value.  This  is  research  work,  which  has  a  technique  different  from  that  of  case 
work,  but  the  suggestion  may  well  be  used  by  case  workers  in  difficult  situations. 
Writing  of  a  certain  cemetery  that  keeps  good  records,  the  investigator  says, 
“Given  one  name  and  the  approximate  date  of  death,  the  records  show  names  and 
dates  of  burial  of  all  persons  buried  in  a  certain  grave  or  family  plot.  Then  still 
other  records  show,  for  each  interment,  age,  place  of  birth,  occupation,  cause  of 
death,  residence  at  time  of  death,  name  of  attending  undertaker.  This  makes  vague 
information  more  definite  and  introduces  to  relatives  not  named.” 

A  few  illustrations  of  the  incidental  use  of  more  formal  public 
records  as  a  means  of  revealing  whereabouts  follow.  The  first 
bears  indirectly  upon  a  matter  that  often  puzzles  the  social  worker, 
especially  in  the  use  of  public  resources,  namely,  upon  legal  resi¬ 
dence.  It  often  happens  that  a  long  and  difficult  social  treatment 
process  is  suddenly  checked  and  made  of  no  avail  by  the  discovery 
that  the  proposed  inmate  or  beneficiary  has  no  legal  residence  in 
the  state  in  which  he  is  living.  The  use  of  private  resources  is  not 
so  rigidly  restricted,  and  the  settlement  laws  that  limit  the  action 
of  public  agencies  in  some  of  our  states  will  undoubtedly  become 
less  rigid  in  time.  Meanwhile,  it  is  necessary  to  have  legal  residence 
in  mind  and  to  know  how  to  establish  it. 

A  state  department  for  the  care  of  children  discovered  in  the  course  of  verifying 
the  ages  of  the  1 1  children  of  a  certain  family  by  means  of  the  state  registry  of  births, 

261 


SOCIAL  DIAGNOSIS 


that  several  of  them  were  born  in  a  town  in  which  their  parents  were  not  known  to 
have  lived,  but  in  which  they  had  had  a  legal  residence. 

In  a  manuscript  on  Investigation  at  a  Distance,  Miss  Alice  Higgins  (Mrs.  Wm. 
H.  Lothrop)  tells  how  the  examination  of  a  marriage  record  revealed  the  maiden 
name  of  an  absent  wife  and  her  birthplace  in  a  small  town  in  another  state.  A 
letter  to  a  clergyman  there  led  to  his  advertising  for  her  in  the  local  newspaper. 
This  advertisement  was  seen  by  the  wife’s  cousin,  who  promptly  notified  her,  and 
caused  her  to  visit  the  offices  of  the  associated  charities.  She  was  able  to  give 
information  and  intelligent  advice  in  a  perplexing  situation. 

Consultation  of  the  court  records  in  a  town  where  a  family  had  lived  only  a  few 
weeks  revealed  to  a  charity  organization  society  the  earlier  movements  of  the 
family’s  deserting  head. 

A  record  of  death  in  a  hospital’s  files  brought  to  light  the  whereabouts  of  the  only 
responsible  relative  of  a  deceased  Italian,  whose  family  were  in  distress  and  applying 
to  a  charity  organization  society.  The  accuracy  of  the  return  on  the  death  record 
had  been  attested  by  a  cousin  of  the  man,  and  this  cousin  was  able  to  give  other 
needed  information. 

A  family  case  worker  reports  that  a  baptismal  record  often  reveals  a  valuable 
source  of  co-operation  by  giving  the  name  and  address  of  a  child’s  godfather  or  god¬ 
mother. 

A  child  labor  committee  reports  that  school  census  records,  where  they  are  fre¬ 
quently  amended,  are  useful  in  searching  for  addresses. 

4.  Property  Records.  Facts  about  property  are  far  more  com¬ 
pletely  on  record  than  facts  about  people;  the  less  highly  organized 
the  community  the  greater  the  disparity  in  value  between  these 
two  kinds  of  record.  The  use  of  property  data — of  records,  that 
is,  of  real  estate,  inheritance,  insurance,  bank  deposits,  pensions, 
and  cemetery  lots — is  so  well  understood  that  it  need  not  be  dwelt 
upon  at  any  length,  though  social  workers  are  still  too  likely  to 
take  hearsay  evidence  and  rumor  with  regard  to  property  instead 
of  having  the  records  searched.1  Their  examination  can  be  effected 
more  quickly  and  accurately  with  the  aid  of  someone  in  a  law  office 
who  is  accustomed  to  this  work. 

Mr.  L.  H.  Levin,  secretary  of  the  Hebrew  Benevolent  Society  in  Baltimore, 
gives  an  instance  of  this  tendency  as  follows:2 

Not  long  ago  an  investigator  reported  that  an  applicant  was  supposed  by  the 
neighbors  to  own  the  house  in  which  he  was  living,  and  this  belief  was  strengthened 
by  the  fact  that  he  had  sold  a  house  a  few  years  previously  and  had  moved  into  this 
one  ostensibly  as  landlord.  The  applicant  and  his  married  son,  who  with  him 

1  See  footnote,  p.  123. 

2  In  one  of  the  short,  unpublished  papers  referred  to  in  the  Preface. 

262 


DOCUMENTARY  SOURCES 


occupied  the  house,  gave  conflicting  statements  as  to  its  ownership,  and  as  the  re¬ 
sult  of  numerous  conferences  and  parleys,  the  investigator  reported  the  applicant 
as  the  probable  owner,  basing  his  judgment  on  the  opinion  of  the  neighborhood,  rein¬ 
forced  by  the  conflicting  statements  of  the  occupants  of  the  house.  After  the  report 
was  in,  the  matter  of  the  ownership  of  the  house  was  referred  to  the  Legal  Aid 
Bureau,  which  reported  that  it  had  belonged  to  the  applicant,  but  had  been  sold  a 
short  time  previously  for  a  small  sum  above  its  encumbrance.  If  the  investigator 
had  known  that  the  ownership  of  the  house  was  a  matter  of  record,  and  that  the 
information  could  be  ascertained  in  a  few  minutes,  not  only  would  he  have  saved 
time  and  trouble,  but  he  would  have  been  able  to  bring  in  an  accurate  report. 

i  It  is  especially  difficult  to  get  any  clue  to  the  possession  of  prop¬ 
erty  by  members  of  certain  foreign  groups.  Their  standard  of 
living  is  low,  they  are  apparently  destitute,  and  are  more  than  will¬ 
ing  to  add  to  their  resources  by  seeking  help  from  funds  that  seem 
to  them  inexhaustible  and  to  be  intended  for  the  aid  of  such  as 
themselves.  These  people  are  not  necessarily  adventurers,  but 
they  are  aliens  and  their  sense  of  individual  responsibility  toward 
our  country’s  social  institutions  has  not  yet  been  developed.  A 
charity  organization  society  in  a  large  city  furnishes  the  following 
illustrations  of  the  concealment  of  property  in  the  Italian  quarter; 
the  habit  of  mind  referred  to  is,  of  course,  not  confined  to  Italians. 

An  organ-grinder  with  four  children,  oldest  aged  nine,  complained  to  the  society 
of  the  laziness  of  his  wife,  who  refused  to  accompany  him  on  his  street  journeys. 
She  was  found  to  be  seven  months  pregnant  and  in  wretched  physical  condition. 
Hospital  care  was  secured  at  once,  but  the  child  was  born  prematurely  and  its 
mother  died.  The  widower  continued  to  apply — for  relief  in  winter,  for  aid  when 
his  organ  went  to  the  factory  for  new  records,  and  for  the  correction  of  his  children, 
who  were  being  cared  for  by  his  aged  mother.  The  Italian-speaking  agent  of  the 
society,  happening  to  pass  the  family’s  door  one  day  soon  after  relief  had  been  given, 
remarked  to  the  grandmother  that  she  would  never  be  able  to  raise  vegetables  in 
the  small  flower  pots  over  which  she  was  working.  Whereupon  the  old  lady  re¬ 
plied  that  their  contents  would  soon  be  transplanted  to  the  lot  that  they  owned. 
Public  records  showed  that  the  man  had  already  paid  $146  on  a  lot  upon  which  he 
still  owed  $89. 

A  woman  recently  widowed  claimed  to  have  received  only  $10  after  the  Italian 
benefit  society  had  paid  her  husband's  funeral  expenses.  Records  of  the  court 
showed,  however,  that  the  mother  had  been  appointed  guardian  of  her  eleven-year- 
old  son’s  estate  and  had  given  bond  in  the  sum  of  $ 1,000 .  This  led  to  the  discovery 
that  the  benefit  society  had  paid  her  $ 200  and  that  there  was  a  $1,000  insurance 
policy  besides.  The  widow  had  been  granted  a  mother’s  pension  of  $20  a  month 
from  public  sources,  but  this  was  revoked  after  these  matters  of  record  came  to  light. 

A  fruit  peddler  was  always  claiming  that  he  was  too  sick  to  work  and  received, 


SOCIAL  DIAGNOSIS 


accordingly,  sick  diet  orders,  clothing  for  the  children  from  their  schools,  free  day 
nursery  care  for  the  younger  ones,  etc.  It  was  learned  later  that  sick  benefits  had 
been  paid  by  his  Italian  society  at  the  same  time.  Finally  a  dispensary  doctor  (not 
Italian)  examined  him,  said  that  he  needed  work,  and  that  his  trouble  was  nervous 
indigestion  which  would  be  helped  by  outdoor  employment.  Started  in  a  fruit 
stand,  he  seemed  to  prosper  and  to  have  a  good  stock,  but  continued  to  appeal  for 
relief.  After  repeated  but  unproved  rumors  that  the  man  had  $ 600  in  bank,  it 
was  suggested  to  him  that  he  sign  a  paper  turning  over  his  property  before  further 
relief  was  given  to  his  family.  This  he  refused  to  do. 

Bank  accounts  are  private  records,  of  course,  and  as  such  can¬ 
not  be  consulted  at  will.  In  some  states,  however,  public  relief 
officials  are  given  by  law  the  right  to  obtain  information  from  banks 
about  the  deposits  of  any  recipient  of  public  relief. 

The  pension  bureau  at  Washington  is  willing  to  give  information 
regarding  recipients  of  government  pensions,  but  not  only  the  name 
and  address  of  the  soldier  or  sailor  inquired  about  must  be  given, 
but  the  full  name  of  the  organization  in  which  he  served,  with  the 
dates  of  enlistment  and  discharge. 

Property,  pension,  and  bank  account  records  are  consulted,  of 
course,  not  only  to  discover  what  clients  have  in  the  way  of  re¬ 
sources,  but  to  find  out  what  they  are  entitled  to  have.  In  a 
certain  case  where  the  damages  awarded  a  workman  against  his 
employer  had  not  been  collected,  the  record  of  a  transfer  of  prop¬ 
erty  by  the  employer  to  his  wife  had  to  be  looked  up  to  learn 
whether  the  transfer  had  been  made  at  about  the  time  of  the  in¬ 
stitution  of  the  suit.  This  was  done  in  order  to  lay  the  basis  for  a 
suit  to  set  the  transfer  aside. 

5.  Immigration  Records.  Records  at  the  port  of  entry  give  not 
only  the  immigrant’s  age  and  last  residence,  but  the  name  and 
address  of  his  nearest  relative  in  the  country  from  which  he  came 
and  the  name  and  complete  address  of  any  friend  or  relative  whom 
he  may  have  been  going  to  join  in  this  country;  also  a  statement, 
regarding  the  money  in  his  possession  on  landing,  and  many  other- 
data  less  likely  to  prove  of  value  to  the  social  worker.  In  order  to 
tap  successfully  this  source  of  information  it  is  important  to  be  able  ► 
to  give  the  immigrant’s  full  name,  his  nationality,  the  name  of  the- 
steamer  and  line  that  brought  him  to  the  United  States,  the  port- 
of  embarkation,  and  the  exact  date  of  arrival ;  though  information 


264 


DOCUMENTARY  SOURCES 


from  the  records  is  known  to  have  been  obtained  when  it  had  been 
possible  to  furnish  an  approximate  date  only. 

Neither  the  immigration  record  nor  the  passports  and  other 
papers  in  the  possession  of  the  immigrant  himself  are  first-hand 
documentary  evidence  as  to  age  or  birthplace.  The  passport  con¬ 
tains  all  data  needed  for  the  identification  of  the  immigration 
record. 

6.  Records  of  Conduct.  If  the  question  has  to  be  settled  of 
placing  a  delinquent  boy  or  girl  on  probation  in  his  own  home  or 
elsewhere,  the  court  records  of  father,  mother,  or  older  brothers 
and  sisters  have  a  direct  bearing  upon  the  decision.  If  our  client 
has  broken  the  law  and  been  arrested,  his  previous  arrests  if  any 
must  be  taken  into  account.  All  work  for  prisoners  and  proba¬ 
tioners,  adult  and  juvenile,  is  very  much  hampered,  at  present,  by 
the  condition  of  court  records,  especially  those  of  the  minor  courts. 
Police  records  of  arrests  are  equally  unsatisfactory;  the  names 
given  on  the  docket  are  often  aliases,  and  other  arrests  may  be 
recorded  in  any  one  or  more  of  a  dozen  different  places.  There  is 
need  of  a  central  registration  of  arrests  and  trials,  with  identifying 
data  that  will  be  accurate  and  unmistakable.  Lacking  this,  public 
officials  and  social  workers  must  know  how  to  use  such  facilities  as 
are  now  at  their  disposal,  must  know  where  to  go  or  write  for  a 
copy  of  a  court  entry,  must  know  the  shortcomings  and  possibilities 
of  the  records  of  indictment,  the  docket  entries,  etc. 

II.  USE  OF  DIRECTORIES  AND  NEWSPAPER  FILES 

Before  turning  to  the  few  suggestions  under  the  head  of  method 
that  are  sufficiently  applicable  to  the  use  of  documents  in  different 
parts  of  the  country  to  be  given  here,  the  consulting  of  printed 
lists  of  names  and  addresses  and  of  the  files  of  newspapers  should 
receive  some  attention. 

City  directories  are  the  most  useful  printed  lists — not  only  the 
current  directory  of  one’s  own  city,  but  the  directories  of  earlier 
years  and  of  other  cities.  These  may  be  consulted  for  a  small 
charge  at  the  local  directory  publication  office,  which  keeps  on  its 
shelves  the  directories  of  all  the  larger  cities  at  least.  Some  large 
manufacturing  concerns  have  collections  of  directories  and  the 
current  directories  of  other  cities  can  often  be  consulted  at  the  local 

265 


SOCIAL  DIAGNOSIS 


board  of  trade.1  Business  directories  are  less  satisfactory  than 
telephone  directories,  which  contain  all  the  business  concerns  of 
any  size  and  are  revised  oftener.  There  are  also  special  telephone 
directories  in  which  subscribers  are  classified  by  the  nature  of  their 
business. 

In  some  states  year  books  are  published  that  contain  lists  of  the 
public  officials  of  the  state  and  counties,  lists  of  city  and  town  offi¬ 
cers,  salaries,  terms  of  office,  the  membership  of  the  legislature,  its 
committees,  the  court  calendars,  the  banks  and  newspapers  of  the 
state,  county  maps,  etc.  A  few  cities  publish  a  civil  list  of  all  city 
officials  and  clerks,  with  their  addresses  and  salaries. 

There  are  a  number  of  trade  directories  such  as  the  one  issued 
by  the  American  Iron  and  Steel  Association,  Hendrick’s  Com¬ 
mercial  Register  of  the  United  States  for  buyers  and  sellers,  etc. 

Professional  directories  of  the  clergymen  of  a  given  denomina¬ 
tion,  of  the  lawyers  of  a  given  city,  of  the  physicians,  of  the  pub¬ 
lic  school  teachers,  etc.,  are  valuable.  Many  religious  denomina¬ 
tions  publish  a  year  book  for  the  whole  country  which  may  not 
only  be  used  in  getting  more  accurately  the  name  of  a  clergyman  in 
a  distant  place,  but  may  discover  there  a  very  serviceable  corres¬ 
pondent.  A  few  cities  publish  special  directories  of  their  social 
agencies,  public  and  private,  and  of  the  medical,  educational, 
remedial,  and  custodial  resources  of  the  community. 

The  following  instances  illustrate  both  the  value  and  the  method 
of  using  directories: 

A  charity  organization  society  telegraphed  to  a  sister  society  a  thousand  miles 
away  in  the  East  that  it  had  been  applied  to  for  a  loan  by  two  women  who  formerly 
lived  in  this  eastern  town  at  addresses  unknown.  Search  of  a  city  directory  five 
years  back  gave  an  entry  of  removal  to  another  state,  but  an  earlier  directory 
gave  a  city  address.  Inquiry  in  the  neighborhood  revealed  their  former  church 
attendance,  and  the  minister  of  the  church  was  able  to  give  a  sympathetic  picture 
of  the  background  and  characteristics  of  these  clients. 

The  head  master  of  an  English  school  wrote  to  an  American  charity  organization 
society  to  discover  the  whereabouts  of  a  brother,  who  had  left  England  eighteen 
years  before  and  had  not  been  heard  from  for  fifteen  years.  At  that  time  he  was 
living  in  a  small  town  in  the  same  state  as  the  society,  but  had  his  mail  sent  to  a 
railroad  office  by  which  he  was  employed  in  the  society’s  own  city.  The  town 

1  The  New  York  Public  Library  has  a  large  collection  of  the  directories  of  Ameri¬ 
can  cities,  going  back  in  some  instances  as  far  as  the  ‘6o’s.  It  also  has  many  Cana¬ 
dian  and  English  directories. 


266 


DOCUMENTARY  SOURCES 


directory  of  nine  years  back  in  the  smaller  place  gave  the  man’s  address  at  a  hos¬ 
pital  where  he  had  served  as  porter,  but  the  hospital  had  lost  all  trace  of  him.  A 
clergyman  in  the  town  was  appealed  to,  who  learned  that  the  man  went  to  a  large 
city  in  another  state  after  he  left  the  hospital,  and  had  married  there,  maiden  name 
of  wife  unknown.  The  charity  organization  society  in  that  city  was  written  to  and 
asked  to  search  marriage  records  and  back  numbers  of  its  city  directory.  The 
marriage  records  revealed  nothing,  but  the  city  directory  did  give  an  English  family 
of  the  same  name,  who  became  interested  in  the  search  and  found  the  missing 
brother  after  two  months’  delay. 

On  p.  1 9 6  the  story  is  told  of  a  homeless  man,  Albert  Gough,  who  was  found  to  have 
escaped  from  an  insane  asylum  and  whose  whereabouts  was  revealed  to  his  relatives 
sixteen  years  after  he  had  last  been  heard  from.  The  process  of  finding  these  rela¬ 
tives  is  what  now  concerns  us.  Gough’s  address  sixteen  years  ago  in  another  state 
and  city  was  sent  to  the  charity  organization  society  there,  with  the  name  of  a  sub¬ 
urb  in  which  he  had  also  lived,  and  the  name  of  the  husband  of  his  sister  Martha, 
one  Joseph  Flynn,  who  had  formerly  worked  for  a  firm  of  Jones  on  Water  Street. 
Another  sister,  Alice,  was  the  wife  of  Peter  O’ Brian.  These  relatives  were  all  found 
in  five  days,  and  the  method  used  was  as  follows: 

All  the  names  mentioned  in  the  letter  of  inquiry  were  first  carefully  looked  up  in 
the  confidential  exchange.1  None  of  the  names  was  found  there,  and  the  inquiry 
was  turned  over  to  one  of  the  society’s  least  experienced  workers  with  the  sole 
suggestion  that  a  city  directory  was  often  a  case  worker’s  best  friend.  After  a 
careful  search  of  every  city  directory  between  the  years  1890  and  1910,  a  list  was 
made  of  the  Joseph  Flynns,  Peter  and  Alice  O’ Brians,  and  Albert  Goughs  contained 
in  each,  with  their  occupations  and  home  addresses.  The  total  entries  thus  listed 
were  56.  Notwithstanding  Gough’s  statement  that  he  had  not  lived  in  the  city 
for  sixteen  years,  it  seemed  worth  while  to  search  the  directory  for  his  name  as  well. 
Nothing  was  found,  however,  more  recent  than  1893,  when  an  Albert  Gough  had 
been  employed  as  carpenter  and  had  boarded  on  Camden  Street,  in  the  neighbor¬ 
hood  of  Norton,  the  suburb  where  Gough  claimed  to  have  been.  This  gave  some 
hope  from  the  very  start  that  his  story  was  true. 

Then  came  the  important  task  of  drawing  the  right  inferences  from  this  mass  of 
material.  The  investigator  put  her  wits  to  work  and  decided  that  only  Flynns  and 
O’ Brians  who  were  living  in  the  city  sixteen  years  ago  would  surely  warrant  a  fol¬ 
lowing-up,  and  that  of  these  only  those  recorded  as  still  living  there  could  easily  be 
traced.  Only  one  Joseph  Flynn  clue  fulfilled  both  these  conditions.  The  follow¬ 
ing  day,  therefore,  with  lively  expectations  of  at  once  discovering  Gough’s  brother- 
in-law,  the  worker  made  a  call  at  this  one  address,  to  find  that  the  family  had  moved. 
She  made  another  call  at  their  new  address,  discovered  with  difficulty,  to  find  that 
they  were  all  out  for  the  day.  To  save  time,  therefore,  and  to  allow  for  the  possi¬ 
bility  that  this  Joseph  Flynn  might  not  be  the  one  that  she  was  seeking,  she  decided 
to  work  also  from  the  other  end  and  try  to  discover  whether  this  Flynn,  an  up¬ 
holsterer,  was  identical  with  a  Flynn,  a  belt  maker,  who  from  1890  to  1904  had 
boarded  in  another  part  of  the  city. 

1  See  p.  303  sq. 

267 


SOCIAL  DIAGNOSIS 


The  neighborhood  proved  Jewish,  and  children  volunteered  the  information  that 
“no  Christians  live  down  here.”  Proprietors  of  nearby  grocery  and  clothing  shops 
were  also  ignorant  of  Flynns,  but  at  last  a  young  woman  in  a  bake  shop  was  found 
who  remembered  the  family  very  well;  the  father,  an  upholsterer,  had  died  nine 
years  ago,  and  his  son,  a  belt  maker,  had  moved  to  Duane  Street.  The  young 
woman  did  not  know  whether  the  younger  Flynn’s  wife  was  named  Martha  or  not, 
but  her  age  corresponded  with  the  probable  age  of  Albert  Gough’s  sister.  Duane 
Street  corresponded  with  an  address  found  in  the  directory  for  1905,  and  assured 
the  investigator  that  this  was  the  same  family  that  she  had  been  seeking  the  day 
before.  As  they  would  not  be  home  until  the  following  day,  she  devoted  a  part  of 
the  afternoon  to  looking  up  a  Mrs.  Alice  O’ Brian  and  making  sure  that  she  was  not 
Gough’s  sister.  Early  the  next  morning  a  visit  to  the  first  family  of  Flynns  left 
her  very  downhearted,  as,  despite  the  fact  that  her  name  was  Martha,  Mrs.  Flynn 
proved  not  to  be  the  sister.  Thus  the  clue  offered  by  the  case  worker’s  best  friend, 
the  directory,  proved  elusive.  There  remained,  however,  the  Jones  firm  on  Water 
Street,  for  the  letter  of  inquiry  had  mentioned  this  additional  clue,  fortunately,  and 
it  was  found  from  an  old  directory  that  a  hardware  firm,  Jones  Brothers,  had  been 
situated  there  eight  years  ago.  From  an  elderly  clerk  in  a  nearby  book  shop  it  was 
learned  that  one  of  Jones  Brothers’  former  clerks  had  a  little  office  on  the  top  floor 
of  the  building  formerly  occupied  by  the  firm.  Here  he  was  found  in  a  little  attic 
room.  He  had  known  the  Joseph  Flynn  employed  by  Jones  Brothers,  thought  that 
he  was  now  living  at  Glenside,  and  knew  that  he  was  working  for  the  Multiple 
Insurance  Company.  A  telephone  message  to  the  insurance  company  brought  the 
Flynn  address  at  Glenside.  Less  than  twenty-four  hours  later  Albert  Gough’s 
sister  had  had  her  first  news  of  him  in  sixteen  years,  during  the  greater  part  of 
which  time  he  had  been  an  inmate  of  a  hospital  for  the  insane  in  a  state  in  which 
he  had  no  friends  or  relatives. 

“We  have  had  occasion  several  times  to  use  the  year  books  of  the  various  religious 
denominations,”  writes  Miss  M.  L.  Birtwell.1  “A  few  years  ago  we  were  trying, 
to  help  a  widow  with  an  aged  mother  and  an  obstreperous  young  son  dependent 
upon  her.  The  woman  was  peculiar;  we  did  not  feel  that  we  understood  her  and 
she  would  give  little  definite  information  about  herself.  The  old  mother  was  feeble, 
almost  in  her  second  childhood,  and  much  inclined  to  beg,  so  not  helpful  in  enabling 
us  to  get  at  the  real  needs  of  the  family.  The  woman  had  a  sister,  but  she  declared 
she  did  not  know  her  exact  name  and  address.  She  was  married,  she  said,  to  a 
Universalist  minister  named  Taylor,  whose  Christian  name  was  a  Bible  name,  and 
she  lived  ’somewhere  in  Vermont.’  We  telephoned  a  request  to  the  Harvard  Di¬ 
vinity  Library  to  consult  the  Universalist  year  book.  They  found  an  Amos  Taylor 
listed  as  pastor  in  the  village  of  K.  Mr.  Taylor’s  wife  proved  to  be  the  sister  of  the 
woman  we  were  interested  in,  and  by  following  up  this  clue  we  learned  the  story  of 
the  woman’s  life,  which  enabled  us  to  deal  with  her  with  a  far  more  sympathetic 
understanding  than  had  been  possible  previously.” 

The  case  reading  for  this  book  brought  to  light  no  illustrations 

1  In  one  of  the  short,  unpublished  papers  referred  to  in  the  Preface. 

268 


DOCUMENTARY  SOURCES 


of  the  use  of  newspaper  files  and  news  indices  to  establish  the  date 
of  one  event  by  associating  it  with  another,  or  to  discover  the  notice 
of  an  accident,  an  arrest,  an  award,  a  death,  a  disappearance,  or 
any  of  the  thousand  and  one  happenings  that  are  recorded  in  the 
daily  press.  Such  clues  are  now  made  more  accessible  to  the  case 
worker  by  N.  W.  Ayer  and  Son’s  annual  list  of  all  newspapers 
printed  in  the  United  States,  by  the  publication  of  indices  to  some 
of  the  leading  papers,  and  by  Bowker’s  Index  to  Dates  of  Current 
Events.  The  latter  aims  to  cover  news  in  the  United  States  which 
is  of  permanent  interest  and  has  more  than  a  local  appeal.  The 
date  given  is  that  of  the  event,  not  of  the  report  of  the  event.  The 
index  goes  back  to  1912  only  as  a  separate  publication.  Indices 
to  the  following  years  and  newspapers,  which  include  their  personal 
news,  are  also  available:  1863-1904,  New  York  Times;  1875- 
1906,  New  York  Tribune;  1891-1902,  Brooklyn  Daily  Eagle; 
1903-1904,  1908-1909,  Street’s  Pandex  of  the  News;  1913  to 
date,  New  York  Times} 

III.  METHOD 

“  In  the  early  days,”  says  Thayer,2  “they  did  not  stick,  it  would 
seem,  at  showing  the  jury  any  document  that  bore  on  the  case, 
without  even  thinking  of  how  the  writer  knew  what  he  said.” 
This  is  the  first  question  to  ask  of  ourselves — How  did  the  writer 
know  the  truth  of  what  he  says?  The  second  is  quite  as  impor¬ 
tant;  namely,  What  interest,  if  any,  had  he  at  the  time  that  he 
wrote  in  representing  things  as  they  were  not?  And  the  third, 
Was  he  trained  to  be  accurate  or  did  his  lack  of  training  render 
inaccuracy  probable?  These  questions  for  the  document  in  the 
writing,  but  its  custody  since  also  has  a  bearing  upon  our  discus¬ 
sion.  We  may  say  that  there  is  no  record  because  we  do  not 
know  how  to  spell  the  key  words  that  would  identify  it,  or  because 
it  has  been  misplaced,  wrongly  indexed,  or  not  indexed  at  all  by 
its  custodians,  or  because,  since  it  came  into  their  custody,  it  has 
been  changed  or  stolen.  Public  records  have  been  well  kept  for  a 
long  time  in  some  places,  in  some  they  have  been  well  kept  for  a 
little  while  only,  and  in  many  they  are  still  abominably  kept .  If 

1  The  list  is  of  indices  on  the  shelves  of  the  New  York  Public  Library,  omitting 
those  that  index  no  personal  news. 

2  Preliminary  Treatise  on  Evidence,  p.  520. 

269 


SOCIAL  DIAGNOSIS 


a  document  is  printed,  a  new  element  of  error  creeps  in.  It  is 
obvious  that  the  mere  failure  to  discover  a  record  after  diligent 
search  is  negative  proof  at  best  and  not  final.  The  record,  when 
found,  is  usually  evidence,  sometimes  proof,  but  seldom  a  conclu¬ 
sive  demonstration. 

“  There  are  three  principles  which  apply  to  the  use  of  records, 
whether  public  or  private/'  says  Miss  Zilpha  D.  Smith.1  “First, 
to  get  a  general  knowledge  of  what  records  are  available,  and,  in 
order  to  determine  their  value,  of  the  methods  by  which  they  were 
gathered.  Second,  to  use  the  earliest  record  of  a  certain  fact  as 
the  most  trustworthy.  Third,  to  consult  the  record  when  it  will 
serve  our  purpose  instead  of  seeking  an  interview,  because  use  of  a 
record  does  not  stir  other  people  to  prejudice  or  action." 

Public  records  in  other  parts  of  the  country  may  be  consulted 
through  public  officials.  There  is  a  charge  in  most  states  for 
transcripts,  especially  certified  transcripts,  and  care  must  be  taken, 
in  writing  to  mayors,  town  clerks,  clerks  of  court,  chiefs  of  police, 
and  others,  to  give  all  possible  identifying  information  with  ac¬ 
curacy  and  to  offer  to  repay  the  necessary  expenses  of  the  search.2 

A  search  for  a  record  should  not  be  limited  to  one  spelling  of 
names  or  to  one  date.  The  dictionaries  used  to  remind  us  that,  in 
order  to  find  a  word,  we  must  know  how  to  spell  it.  This  is  not 
strictly  true,  of  course,  if  we  are  able  to  think  of  a  number  of  spell¬ 
ings  each  of  which  might  possibly  be  the  right  one.  For  foreign 
proper  names,  more  especially,  no  small  degree  of  ingenuity  is 
necessary  in  the  searching  of  records,  because  the  owners  of  the 
names  do  not  always  know  how  to  spell  them,  and  the  custodians 
and  indexers  of  documents  certainly  do  not.  Then  too,  when  an 
Italian  barber  named  Cellini  suddenly  changes  his  name,  under 
influences  social  or  political,  to  Kelly,  the  effect  upon  an  index  is 
disastrous.  The  list  of  variable  spellings  given  in  Appendix  III 
was  prepared  by  the  registration  clerks  of  the  New  York  Charity 
Organization  Society  from  the  much  more  extended  groupings  in 
daily  use  in  their  Social  Service  Exchange.  Each  community 
should  work  out  its  own  list,  with  reference  to  its  local  needs. 

1  In  one  of  the  short,  unpublished  papers  referred  to  in  the  Preface? 

2  The  New  York  City  Bureau  of  Records,  which  is  under  the  Department  of 
Health,  now  assures  greater  accuracy  by  issuing  photographic  copies  of  its  records. 

270 


DOCUMENTARY  SOURCES 


With  the  list  given  in  Appendix  1 1 1  in  his  pocketbook,  the  agent 
of  a  child-saving  agency  would  have  been  saved  a  second  visit  to 
the  public  record  office  in  the  following  case: 

A  girl  seeking  separate  support  from  her  husband  asked  the  children’s  society 
to  take  her  case  into  court.  As  there  was  some  doubt  about  her  marriage,  the 
records  were  searched,  but  without  avail.  A  few  days  later  a  letter  was  received 
from  her  signed  Margaret  Koch.  She  had  spelled  her  husband’s  name  as  Cook  at 
the  time  of  her  visit,  or  so  the  agent  had  understood  it.  Going  back  again  to  the 
record  office,  the  agent  found  the  record  of  marriage  under  the  new  spelling. 

A  worker  in  an  agency  that  has  had  much  experience  with  forced 
marriages  instructs  her  assistants,  in  their  search  for  elusive  public 
records,  to  look  forward  of  the  date  given  when  they  are  looking 
up  marriages,  and  back  of  the  date  given  when  they  are  examining 
records  of  births.  This  would  not  be  a  safe  rule  if  the  birth  or 
marriage  record  of  a  girl  who  claimed  to  be  over  eighteen  when  she 
was  not  so  old  were  in  question;  in  fact,  it  is  not  a  rule  at  all,  but 
it  contains  the  suggestion  that  we  should  look  both  before  and  after 
the  date  given,  looking  first  in  the  direction  in  which  the  variation 
is  most  likely  to  have  occurred. 

A  word  of  caution  about  translators.  When  a  document  is  in  a 
foreign  language  and  no  trustworthy  translator  is  at  hand,  it  may 
be  well  to  seek  the  aid  of  the  consular  office  of  the  country  whence 
the  document  came. 

In  the  foregoing  statements  about  public  records  and  where  to 
find  them,  it  has  been  impossible  to  give  more  than  a  generalized 
view,  because  there  is  no  uniform  record  system  in  our  48  states. 
A  social  case  worker  should  know  what  public  records  are  available 
in  his  own  city  and  state,  should  know  in  general  their  lacks  in 
fullness,  accuracy,  and  accessibility,  and  should  be  prepared  to  do 
his  part  in  procuring  a  better  system  of  records. 

SUMMARY  OF  THIS  CHAPTER 

1.  Documents  both  printed  and  unprinted  may  be  divided  into  original  and 
derivative.  The  derivative  record,  when  a  copy,  cannot  be  accurate  if  the  original 
is  not. 

2.  Documentary  Sources  are  most  satisfactory  in  those  objective  matters  of  time, 
place,  amount,  procedure,  etc.,  in  which  accuracy  is  vital.  They  are  least  satis¬ 
factory  in  those  matters  of  personal  experience  and  human  relation  in  which  the 
motives  and  capacity  of  the  witness,  the  atmosphere  and  spirit  of  his  statement, 
are  all  important. 

271 


f 


SOCIAL  DIAGNOSIS 


3.  Social  case  workers  consult  documents  most  frequently  for  facts  about  birth, 
death,  marriage,  divorce,  whereabouts,  property,  immigration,  and  conduct. 

4.  Many  documents  are  utilized  in  establishing  dates  of  birth,  such  as  certifi¬ 
cates  of  birth,  baptismal  certificates,  immigration  records,  naturalization  papers, 
insurance  policies,  Bible  and  other  religious  records,  court  records,  hospital  records, 
children’s  institution  records,  and  the  records  of  other  social  agencies.  Not  all 
of  these  are  of  equal  value.  The  record  made  at  or  near  the  time  of  birth  is  the 
most  trustworthy. 

5.  The  chief  sources  for  proof  and  for  date  of  death  are  the  records  of  the  board 
of  health  and  of  hospitals. 

6.  The  sources  for  proof  and  for  date  of  marriage  are  the  records  of  marriage 
licenses  and  marriages  (civil)  and  of  marriage  ceremonies  (church).  There  are 
often  minor  differences  of  date,  such  as  differences  between  the  date  of  issuing  the 
license,  the  date  of  the  ceremony,  and  the  date  of  reporting  the  ceremony. 

7.  Records  of  birth,  death,  marriage,  property,  etc.,  often  reveal  the  whereabouts 
not  only  of  members  of  the  immediate  family  but  of  their  friends  and  connections. 
Other  sources  for  whereabouts  are  directories,  voting  lists,  enlistment  records, 
police  precinct  books,  receipts  of  foreign  drafts,  and  cemetery  records. 

The  most  useful  and  accessible  source  of  all  is  the  directories,  both  special  and 
general,  for  current  and  earlier  years.  Boards^of  trade,  certain  large  manufacturers, 
the  publishers  of  directories,  and  a  few  large  libraries  have  files  of  the  directories 
of  other  cities.  Every  case  worker  should  learn  to  consult  directories  promptly 
and  skilfully. 

8.  Property  data  appear  in  records  of  real  estate,  inheritance,  insurance,  bank 
deposits,  pensions,  and  cemetery  lots. 

9.  Records  of  arrest  and  of  trial  often  give  important  data  as  regards  conduct. 

10.  The  date  of  an  event  may  sometimes  be  established  by  its  association  with 
another  event,  the  date  of  which  is  matter  of  record.  Newspaper  files  and  an  index 
to  dates  will  be  found  useful  in  this  connection.  Back  files  of  newspapers  and  their 
indices  also  bring  to  light  notices  of  such  personal  incidents  as  an  accident,  an  arrest, 
an  award,  a  death,  a  disappearance,  etc. 

11.  In  the  search  for  and  use  of  documents  we  must  consider  in  each  case  the 
disinterestedness  of  their  authors  and  the  carefulness  of  their  custodians.  How  did 
the  writer  know  the  truth  of  what  he  wrote,  and  what  interest  had  he  in  writing  it 
thus  and  not  otherwise?  Then  failure  to  find  a  record  may  be  due  to  our  or  to  the 
writer’s  misspelling  of  the  key  word,  to  wrong  indexing,  or  to  theft. 

12.  A  search  for  a  record  should  not  be  limited  to  one  spelling  or  to  one  date. 
Lists  of  variable  spellings,  especially  of  foreign  names  (see  brief  example  in  Ap¬ 
pendix  III)  will  be  found  serviceable. 


272 


I 


CHAPTER  XIV 


NEIGHBORHOOD  SOURCES 


WE  come  now  to  a  group  of  sources  that,  measured  by  their 
value  to  the  diagnostician,  are  on  a  lower  plane  than 
any  that  have  yet  been  discussed.  Neighborhood  evi¬ 
dence  is  often  the  synonym  for  gossip  and  inaccuracy.  There  are 
situations  in  which  the  testimony  of  a  present  neighbor  may  be 
indispensable,  but  in  social  work  these  are  the  exception,  and  no 
fact  could  better  illustrate  the  crudity  of  much  of  our  social  treat¬ 
ment  than  the  discovery  that,  at  the  time  that  our  statistics  of 
outside  sources  were  gathered,  present  neighbors  were  found  to  be 
more  frequently  consulted  in  one  of  the  three  cities  studied  than 
any  other  one  source.1  Neighborhood  Sources  in  order  of  frequency 
of  use  in  the  three  cities  ranked  as  follows: 


First  City 

Second  City 

Third  City 

Present  neighbors 

9th 

3rd 

1st 

Present  landlords  2 

1 8th 

4th 

5th 

Present  local  tradesmen 

29th 

24th 

20th 

Former  neighbors 

13th 

12th 

15th 

Former  landlords 

1 6th 

5th 

1 6th 

Former  local  tradesmen 

33rd 

36th 

27th 

Reference  to  Appendix  II,  Table  B,  shows  in  the  first  city  (where 
no  evidence  was  found  of  a  general  tendency  to  lean  too  heavily 
upon  Neighborhood  Sources)  a  good  deal  of  diversity  of  use  as  be¬ 
tween  one  agency  and  another  having  the  same  general  purpose. 
One  placing-out  agency  consulted  present  neighbors  not  once  in 
its  50  cases,  and  another  consulted  them  27  times.  On  the  whole, 
however,  their  use  in  this  city  seems  to  be  largely  confined  to  the 
protection  of  children  from  neglect,  to  the  public  care  of  children, 
and  to  adult  probation.  They  are  usually  avoided  by  the  family 
rehabilitation  agencies  and  still  used,  apparently,  by  other  relief 
administrators. 

1  Excluding  social  agencies  as  a  source. 

2  Including  owners,  agents,  and  janitors. 

273 


18 


SOCIAL  DIAGNOSIS 


In  the  sections  that  follow,  the  use  of  Neighborhood  Sources  is 
considered  under  the  subheads  of  present  neighbors,  former  neigh¬ 
bors,  landlords,  and  other  Neighborhood  Sources. 

I.  PRESENT  NEIGHBORS 

The  worst  example  of  interviewing  present  neighbors  that  has 
come  to  the  attention  of  the  writer  is  that  of  a  public  outdoor  relief 
agent  who  habitually  visited  neighborhood  tradesmen,  janitors, 
etc.,  before  seeing  the  family,  and  tried,  by  leading  questions,  to 
draw  out  anything  unfavorable  about  them  that  could  be  either 
suggested  or  uncovered.  These  are  the  methods  not  of  the  diag¬ 
nostician  but  of  the  inquisitor.  Such  abominable  practices  are 
not  confined  to  public  outdoor  relief  departments,  of  course.  Un¬ 
fortunately  the  reaction  against  them,  wherever  they  are  found, 
easily  takes  the  form  of  protest  against  every  kind  of  inquiry. 

The  objections  to  present  neighbors  as  sources  of  information 
may  be  stated  in  a  word.  They  are  likely  to  be  biased  by  a  desire 
to  do  a  favor  or  to  pay  off  a  grudge.  Their  questioning  works  un¬ 
due  hardship,  moreover,  to  the  subject  of  the  inquiry,  exposing 
him  to  gossip  and  humiliation  without  securing  any  insights  that 
could  not  be  arrived  at  better  in  some  other  way.  “  My  mere  ap¬ 
pearance  at  a  family’s  door,”  said  a  probation  officer,  ‘'advertises 
to  the  whole  neighborhood  that  there  is  trouble  in  the  family,  and 
I  have  as  little  to  do  with  the  neighbors  as  possible.”  “We  have 
to  use  them  for  court  evidence,”  writes  the  head  of  a  society  for 
the  protection  of  children,  “but  we  use  them  as  little  as  possible, 
and  always  try  to  secure  othei^vidLeni^Jn^^-additionr-Fealizing  that 
their  evidence  is  of  the  most  prejudiced  kind,  either  strong  for  the 
family  or  else  harboring  a  grudge.” 

The  circumstances  under  which  we  are  justified  in  seeing  present 
neighbors  have  been  so  well  described  by  Miss  Amelia  Sears  in  a 
short  paper1  that  it  is  given  here  practically  in  full: 

4k 

The  visiting  of  present  neighbors  has  been  compared  to  that  last  resort  of  the 
surgeon — the  exploratory  incision,  permissible  only  when  every  other  means  of 
diagnosis  is  exhausted  and  the  condition  of  the  patient  admits  of  no  delay.  Perilous 
situations  permit  of  untoward  measures;  danger  inherent  in  the  family  situation  so 
serious  as  to  necessitate  immediate  and  decisive  action  justifies  recourse  to  any  ex¬ 
pedient.  Physical  and  moral  danger  within  the  family  indicates  one  of  two  condi- 

1  One  of  the  unpublished  papers  referred  to  in  the  Preface. 

274 


NEIGHBORHOOD  SOURCES 


tions — mental  instability  or  moral  turpitude.  Illustrative  of  the  former  we  have 
the  spectacle  of  an  epileptic  insane  father  of  three  small  children.  He  suffers  from 
frequent  seizures  and  is  shielded  by  the  mother  who,  by  her  defense,  blocks  all  efforts 
to  have  him  judged  insane.  He  is  finally  placed  under  confinement  by  the  testi¬ 
mony  of  present  neighbors. 

In  spite  of  the  harshness  incident  to  the  visiting  of  present  neighbors,  it  is  con¬ 
ceivable  that  the  process  may  prove  beneficial  to  families  needing  legal  protection. 
A  refined  German  widow  and  her  son,  a  mechanic  of  thirty,  were  both  possessed  of 
fixed  delusions  of  persecution,  delusions  which  precluded  their  giving  information 
about  friends  or  relatives.  The  mother,  when  interviewed  by  a  physician,  who  had 
called  at  the  visitor’s  request,  was  sufficiently  cunning  to  conceal  her  mental  state 
and  send  him  away  convinced  there  was  no  condition  which  justified  his  interference. 
The  next  step,  a  deliberate  and  systematic  canvass  of  the  neighborhood,  revealed 
many  startling  facts  about  the  couple  but  nothing  sufficiently  conclusive  until  a 
neighbor  stated  that  a  physician  had  been  seen  to  enter  the  home  some  weeks  before. 
The  clue  was  followed  up,  and  upon  the  evidence  of  this  second  physician,  who  was 
an  alienist,  both  mother  and  son  were  placed  in  a  state  hospital  for  the  insane. 

Many  as  are  the  manifestations  of  mental  instability  which  threaten  family 
integrity,  they  do  not  present  the  intricacies  of  investigation  which  are  offered  by 
the  various  types  of  immorality,  including  licentiousness,  theft,  fraud,  begging, 
begging  letter  writing,  abuse  of  children  other  than  physical,  brutality,  and  extreme 
intemperance.  These  latter  conditions  not  only  justify  but  they  demand  recourse 
to  any  and  every  means  that  may  give  needed  protection  to  children. 

The  investigation  of  such  family  situations,  besmirched  as  they  often  are,  pre¬ 
sents  exceptional  difficulties;  not  only  must  the  truth  be  discovered  regarding  people 
who  are  interested  in  evading  discovery  and  many  of  whose  associates  are  of  ques¬ 
tionable  character,  but  also  the  truth  must  be  discovered  so  conclusively  that  it  is 
possible  to  provide  witnesses  possessing  first-hand  knowledge  of  the  degraded  con¬ 
ditions  and  willing  to  testify  to  the  same.  Often  only  through  a  united  effort  of  the 
charity  organization  society  and  the  court  agencies  is  there  a  chance  of  discovering 
the  facts  and  of  securing  evidence  sufficient  to  safeguard  the  children  whose  welfare 
is  involved. 

For  instance,  the  investigation  of  the  cause  of  disintegration  of  the  D  family 
began  in  the  court  and  was  carried  thence  to  the  charity  organization  society.  The 
original  action  was  brought  by  the  father,  who  requested  that  the  judge  of  the 
juvenile  court  place  his  children  in  institutions,  claiming  that  his  wife  drank 
heavily  and  failed  to  give  them  proper  care.  On  the  first  hearing,  Mrs.  D  was 
exonerated,  the  children  sent  home,  and  the  father  ordered  to  contribute  weekly 
to  their  support.  Mrs.  D  instituted  the  second  hearing,  claiming  that  Mr.  D  was 
disobeying  the  court  order,  whereupon  Mr.  D  was  incarcerated  in  the  county  jail 
for  contempt  of  court.  Interviews  with  the  wife  in  the  home  and  the  husband  in 
the  jail  were  contradictory  in  the  extreme,  and  relatives  and  references  of  both 
were  so  partisan  as  to  make  it  well-nigh  impossible  to  learn  conclusively  if  the  wife 
drank  to  excess,  which  seemed  to  be  the  crux  of  the  situation.  An  unsophisticated 
drugstore  clerk  interviewed  during  a  canvass  of  the  neighborhood  cleared  up  the 


275 


SOCIAL  DIAGNOSIS 


whole  matter  by  naively  stating  he  was  in  the  habit  of  selling  liquor  to  the  D  chil¬ 
dren  for  their  mother’s  use;  a  statement  of  quantities,  dates,  and  hours  at  which  it 
was  sold  brought,  when  produced  in  court,  the  first  conclusive  evidence  to  the  atten¬ 
tion  of  the  much  troubled  judge. 

Similarly,  court  officials  and  the  charity  organization  society  united  to  secure 
data  sufficient  to  satisfy  the  judges  of  two  courts  in  which  various  members  of  the 
C  family  were  simultaneously  arraigned.  Pending  the  collection  of  evidence, 
Mrs.  C  was  released  from  the  municipal  court  on  suspended  sentence,  having  been 
charged  with  open  and  notorious  adultery,  and  the  children  were  paroled  from  the 
juvenile  court,  pending  the  disposition  of  their  mother’s  case.  The  school  and  the 
landlord  and  various  relatives  were  willing  to  give  general  statements;  it  remained, 
however,  for  the  neighbors  in  the  rear  tenement  on  the  same  lot  to  produce  the  evi¬ 
dence  of  an  eye  witness  necessary  to  convict  the  mother. 

The  rule  of  visiting  present  neighbors  only  in  cases  necessitating  court  evidence 
holds  in  relation  to  families  in  which  possibly  there  is  little  viciousness,  but  where  the 
abuse  of  the  children  is  the  result  of  ignorance  and  of  low  standards. 

The  old  grandmother  and  the  drunken  uncle  to  whom  Grace  and  Johnny  M  were 
paroled  from  the  juvenile  court  never  meant  to  harm  the  children,  but  still  the 
home  was  unfit  and  a  menace  to  the  children,  both  of  whom  were  subnormal.  The 
efforts  of  the  probation  officer  to  secure  sufficient  evidence  to  remove  the  children 
from  this  home  were  curiously  frustrated  by  the  fact  that  during  the  last  months 
Johnny  had  improved  continuously  and  unaccountably  in  health,  appearance,  and 
even  weight,  in  view  of  which  fact  it  was  difficult  to  persuade  the  judge  that  the 
home  was  entirely  unfit.  The  explanation  came  when  the  visitor  seeking  evidence 
of  carousals  in  the  home  unexpectedly  found  the  “good  neighbor”  in  the  baker’s 
wife,  who  proudly  accounted  for  Johnny’s  improvement  by  the  fact  that  she  had  fed 
him  regularly  for  weeks  and,  of  late,  mightily  interested  in  his  improvement,  had 
also  been  weighing  him  regularly. 

The  justification  of  the  use  of  any  method  of  investigation  as  harsh  as  this  visiting 
of  present  neighbors  exists  only  in  its  beneficent  results  to  the  family.  If  we  grant 
that,  as  stated  in  the  beginning,  the  use  of  this  method  is  limited  to  such  family 
situations  as  contain  inherent  dangers,  and  keep  in  mind  the  solution  of  the  family 
difficulties  compatible  with  the  best  and  lasting  interest  of  all  concerned,  it  is  con¬ 
ceivable  that  this  conquering,  this  gaining  the  ascendancy  through  force — mental 
not  brute,  it  is  true,  but  still  through  force — may  prove  the  only  means  of  aiding  the 
family. 

This  was  written  when  Miss  Sears  was  the  district  secretary  of 
a  charity  organization  society  and  it  gives  the  point  of  view  of  a 
family  rehabilitation  agency.  Its  findings  are  confirmed  by  our 
case  record  reading  in  other  social  agencies. 

The  records  of  an  S.  P.  C.  C.  show  many  instances  of  the  usefulness  of  present 
neighbors  in  securing  proof  of  insanity,  of  immorality,  of  the  need  of  other  guar¬ 
dians  for  children,  or  of  their  physical  abuse.  These  records  also  show  that  neighbors 
are  capable,  out  of  pure  spite,  of  lodging  unjustifiable  complaints  against  parents. 

276 


NEIGHBORHOOD  SOURCES 


A  hospital  social  service  department  finds  neighbors  invaluable  in  insanity  cases. 
One  such  case  was  that  of  a  woman  about  whose  daily  ways,  as  evidence  of  her  in¬ 
sanity,  it  was  difficult  to  get  any  information.  A  neighbor  in  the  same  house  helped 
the  department  to  procure  a  clear  picture.  Another  patient  came  to  the  hospital 
in  such  an  excitable  state  that  she  was  probably  too  dangerous  to  leave  at  large. 
One  of  the  hospital  social  workers  took  her  home,  but  found  no  one  there.  A  neighbor 
in  the  same  tenement  house  gave  the  necessary  addresses  of  the  patient’s  children. 

A  woman  who  was  keeping  a  disorderly  tenement  petitioned  the  court  for  a  revo¬ 
cation  of  the  decree  that  made  a  social  worker  the  guardian  of  her  thirteen-year-old 
daughter.  The  mother’s  petition  was  denied  after  a  long  hearing.  She  afterwards 
told  a  probation  officer  that  the  case  was  going  her  way  at  the  trial  until  a  neighbor 
testified  whose  apartment  was  immediately  over  hers.  When  seen  before  the  trial, 
the  woman  s  landlord  and  the  police  had  denied  that  anything  was  wrong,  though 
the  tenant  had  been  in  jail  before  on  the  charge  of  keeping  a  disorderly  house. 
In  court,  however,  the  police  cohfirmed  the  neighbor’s  story. 

There  is  great  difficulty  in  persuading  neighbors  to  tell  in  court 
what  they  know  about  the  neglect  and  physical  abuse  of  children, 
and  often  no  other  witnesses  can  be  secured  to  testify  to  the 
specific  acts  of  cruelty  justifying  removal. 

A  school  principal  complained  to  the  S.  P.  C.  C.  that  a  stepmother  was  suspected 
of  abusing  her  husband  s  children.  One  neighbor  said,  when  seen,  that  the  step¬ 
mother  had  been  drinking  and  carousing  for  more  than  two  years  back.  A  second, 
a  city  employe,  said  that  he  could  tell  a  horrible  tale  if  he  would,  but  that  it  was  none 
of  his  business.  A  third  had  seen  the  small  girl  hard  at  work  before  5  a.  m.  The 
city  employe  was  summoned  at  the  trial  but  did  not  appear,  and  the  court  returned 
the  children  to  the  home  to  see  whether  they  would  not  be  treated  better.  But 
how  was  this  to  be  ascertained?  The  wife  of  the  witness  who  failed  to  appear  was 
seen  and  reported  further  fighting,  indecent  talk,  and  the  girl’s  being  dragged  into 
the  house  by  the  hair  of  her  head  by  the  stepmother,  but  this  informant  would  not 
go  into  court  because  she  was  afraid  of  the  woman  in  question.  Another  neighbor 
confirmed  this  story,  but  also  refused  to  testify.  There  was  no  difficulty  in  getting 
a  number  of  statements  that  tallied  in  all  important  particulars,  but  there  was  not 
a  court  witness  among  them. 

The  same  society  received  an  anonymous  complaint  that  the  children  were  neg¬ 
lected  in  a  certain  family.  Their  mother  said  that  the  complaint  must  have  come 
from  colored  neighbors  with  whom  she  had  quarreled.  The  policeman  on  the  beat, 
the  visiting  housekeeper  of  the  charity  organization  society,  and  the  children’s 
teacher  all  believed  that  the  charge  was  unfounded.  The  family  was  persuaded  to 

move  to  a  better  neighborhood,  and  the  charity  organization  society  continued  its 
visits. 

Critical  comments  on  the  records  of  a  large  family  agency  con¬ 
tain  the  following:  "Much  of  the  information  gathered  from 
present  housekeepers  and  janitresses  is  contradictory  and  of  nega- 

277 


SOCIAL  DIAGNOSIS 


tive  value.  Often  it  is  one-sided,  and  often  totally  misleading. 
The  reason  for  using  this  source  and  statements  from  previous 
residences  which  are  near  the  present  one  is  that  they  are  easiest 
to  get.”  Consultation  with  such  sources  to  the  exclusion  of  better 
ones,  or  their  frequent  use  at  all  in  cases  not  requiring  court  action, 
marks  a  low  degree  of  social  skill. 

II.  FORMER  NEIGHBORS 

Under  the  head  of  former  neighbors  may  be  included  the  tenants 
at  each  former  residence,  the  neighbors  living  nearest  to  these  who 
were  there  at  the  same  time  as  our  client,  the  local  tradesmen,  and 
the  landlords  or  real  estate  agents  who  rented  to  our  client,  also 
the  housekeepers,  janitresses,  etc.,  connected  with  the  properties. 
Landlords  and  tradesmen  will  be  considered  separately. 

When  removal  has  been  only  a  short  distance  away,  or  when  the 
community  is  a  small  one,  some  of  the  objections  made  to  inter¬ 
viewing  present  neighbors  apply  also  to  seeing  former  ones.  In 
neighborhoods  well  removed  from  the  present  residence  inquiries 
quietly  made  do  no  harm  and  sometimes  reveal  facts  of  value, 
especially  in  those  obscure  cases  in  which  the  evidence  is  very 
contradictory  or  in  which  clues  are  not  plentiful.  The  former 
neighbor’s  experience  is  removed  from  the  enthusiasms  and  irrita¬ 
tions  of  daily  intercourse  and  has  acquired  a  certain  degree  of 
perspective.  It  is  still  open  to  the  objection,  however,  that  it  is 
liable  to  be  the  experience  of  one  who  is  not  a  good  observer. 
Especially  important,  in  recording  such  statements,  therefore,  is 
the  habit  of  writing  beneath  them  an  evaluation  of  the  witness’s 
personality.  Such  brief  impressions  must  be  clearly  set  apart  as 
impressions  only,  though  it  is  often  possible  to  add  to  them  the 
testimony  of  others,  such  as,  “has  a  good  name  in  the  neighbor¬ 
hood  for  trustworthiness,”  “said  by  the  local  tradesmen  to  be 
quarrelsome,”  “standing  in  the  community  unusually  good;  re¬ 
garded  as  a  leader  by  his  fellow-countrymen,”  etc. 

When  our  list  of  clues  includes  five  or  six  previous  residences,  a 
good  principle  of  choice  is  to  select  those  in  which  the  client  has 
lived  the  longest  during  the  last  five  years.  It  may  be  necessary, 
should  we  obtain  contradictory  statements  from  these,  to  visit  all 
the  others. 


278 


NEIGHBORHOOD  SOURCES 


If  a  family  has  arrived  from  another  city  and  has  immediately 
become  dependent,  previous  residences  in  other  places  may  be  our 
only  clues  outside  the  family  group  at  first,  and  out  of  these  scant 
materials  a  plan  of  treatment  must  be  devised.  Where  there  have 
been  many  changes  of  both  residence  and  neighborhood  within  the 
same  city,  the  character  of  the  different  neighborhoods  is  some 
indication  of  an  upward  or  downward  trend  in  standard  of  living — 
often  too  the  very  time  at  which  the  stream  of  the  family  life  was 
bent  from  its  natural  course  is  thus  suggested. 

Sometimes  unfavorable  rumors  in  present  neighborhoods  are 
disproved  by  a  former  neighborhood  record.  Sometimes,  on  the 
other  hand,  the  withholding  of  all  clues  to  trustworthy  informa¬ 
tion  is  one  sign  among  others  of  arf anti-social  purpose,  and  it  is 
necessary,  for  the  protection  of  innocent  people  whose  welfare 
is  directly  involved,  or  even  for  the  protection  of  the  community 
in  some  cases,  to  push  forward  with  whatever  slender  thread  may 
be  discoverable.  Here,  too,  the  first  clue  is  likely  to  be  a  previous 
residence.  Thus,  we  are  able  to  utilize  former  neighborhoods  in  a 
number  of  ways  that  are  not  only  different  from  but  less  hazardous 
than  present  neighborhood  uses. 

The  matron  of  a  children’s  charity  reported  of  a  certain  cobbler  whose  family 
were  in  distress  that  a  relative  of  hers,  who  lived  in  the  neighborhood,  heard  that 
the  man  was  employing  three  assistants  and  doing  unusually  well.  At  the  cobbler’s 
former  residence  and  shop  this  rumor  was  discredited. 

In  a  city  in  which  the  charitable  work  for  families  had  recently  been  reorganized 
and  an  attempt  made  to  substitute  the  idea  of  rehabilitation  for  the  old,  promiscu¬ 
ous  dosing,  a  citizen  asked  the  reorganized  agency  to  visit  a  woman  who  had  been  a 
persistent  beggar  for  many  years,  adding,  in  the  letter  containing  the  request,  this 
suggestive  sentence:  ‘  Our  agencies  have  looked  after  her  many  times,  but  I  feel 
that  some  action  should  be  taken  to  change  the  general  condition  of  her  life,  so  that 
neither  an  organisation  nor  individuals  should  he  called  upon  to  make  so  many  decisions 
per  year  in  her  behalf”  Expert  after  fifteen  years  of  experience  with  the  aimless 
questioning  of  many  different  givers,  the  woman  would  give  very  little  information 
about  herself  except  a  long  recital  of  misfortunes  and  the  statement  that  her  only 
child  was  feeble-minded.  She  did  happen  to  mention  one  previous  residence,  however, 
and  near  it  was  found  a  housewife  who  had  lived  in  the  same  place  for  years  and 
knew  that  her  former  neighbor  had  several  children,  one  of  whom  was  a  police¬ 
man.  When  the  policeman  was  seen  at  his  home,  he  told  of  three  married  brothers 
and  sisters,  and  of  seven  uncles  and  aunts,  some  of  them  well-to-do.  So  far  as 
could  be  discovered,  none  of  these  had  ever  been  conferred  with  before  by  the 
agencies  that  had  been  making  the  “many  decisions  per  year,”  nor  had  any  evi- 

279 


SOCIAL  DIAGNOSIS 


dence  been  brought  to  light  before  that  the  woman’s  begging  was  a  monomania,  as 
proved  to  be  the  case. 

These  supplementary  clues  to  other  sources  (in  the  case  just 
cited  clues  furnished  by  the  former  neighbor  to  the  married  chil¬ 
dren  and  by  them  to  the  other  relatives)  are  among  the  best 
results  of  former  neighborhood  visits. 

There  is  a  great  deal  of  evidence  at  hand,  as  a  result  of  case 
reading,  of  the  extreme  untrustworthiness  of  the  ordinary  run  of 
former  neighborhood  opinion.  The  following  are  fair  examples: 

“At  302  E  Street  landlord  not  at  home;  neighbors  said  family  were  a  hard  lot; 
man  and  woman  drinking  all  the  time;  evicted  on  account  of  non-payment  of  rent. 
Had  lived  in  house  five  years.  Man  had  been  discharged  from  the  railroad  because 
he  ran  over  a  child  and  killed  it.  Said  he  was  all  right  except  for  drink,  but  woman 
was  a  wicked,  bad  creature.”  The  evidence  of  the  former  landlord,  seen  later,  of 
the  former  employers  of  the  man  and  of  the  woman,  and  of  the  family  doctor  proved 
that  these  statements  were  altogether  untrue. 

The  janitress  at  the  former  address  “has  lived  there  about  five  years.  Knew 
all  about  the  family.  Says  she  is  a  beautiful  lady,  and  that  the  husband  gambles. 
‘She  drank  a  little  but  nothing  to  hurt,’  and  more  in  the  same  strain.”  Further 
inquiry  brought  out  the  truth — the  janitress  and  the  subject  of  the  investigation 
used  to  drink  together,  and  both  were  untrustworthy. 

“It  is  necessary  to  remember,”  writes  Francis  H.  McLean, 
“that  while  others  whom  we  consult  may  mislead  .  .  .  here 

we  enter  the  domain  of  mere  gossip.  .  .  .  Is  it  not  fair  to  say 
that  one  ordinarily  cannot  expect  to  receive  a  just  picture  of  the 
whole  family  from  the  angle  of  the  old  neighborhood  connections, 
but  that  they  may  bring  certain  concrete  elements  into  relief?  ”l 

So  much  for  neighborhood  statements,  but  we  must  not  forget 
that  neighborhoods,  both  past  and  present,  speak  for  themselves, 
that  the  physical  condition  of  the  house  lived  in 2  and  its  environ¬ 
ment — the  character  of  the  shops,  the  streets,  the  local  amusements, 
the  play  facilities — are  all  eloquent  to  one  who  brings  to  them  an 
observant  eye  and  a  good  basis  of  comparison. 

III.  LANDLORDS 

Here  as  with  employers  and  neighbors  we  must  discriminate 
between  present  and  former.  The  present  landlord  is  to  be  avoided, 

1  In  one  of  the  short,  unpublished  papers  referred  to  in  the  Preface. 

2  See  p.  1 5 1. 


280 


NEIGHBORHOOD  SOURCES 


usually,  by  any  agency  whose  connection  with  a  tenant,  if  known, 
would  be  liable  to  create  prejudice  against  him.  The  landlord  has 
been  known,  also,  to  take  advantage  of  any  new  philanthropic 
interest  to  secure  better  returns  from  his  property,  and,  as  the 
relation  between  landlord  and  tenant  is  a  business  one,  it  had 
better  remain  undisturbed.  When  this  statement  was  made  to  a 
group  of  social  case  workers,  two  of  them  protested.  One  of  these 
worked  in  a  small  southern  city  where,  in  his  experience,  landlords 
were  actually  more  lenient  with  their  tenants  when  they  knew  that 
the  associated  charities  was  trying  to  help  them.  The  other  worker 
was  a  district  secretary  in  the  Polish  section  of  a  large  city,  where 
many  of  the  Polish  landlords  reported  their  tenants  to  the  district 
office  for  assistance  as  soon  as  they  failed  to  pay  their  rent  promptly. 
The  first  knew  best  a  group  of  landlords  who  wished  to  share  the 
social  agency’s  burden;  the  second  had  in  mind  a  group  who 
wished  the  society  to  help  them  rather  than  their  tenants.  The 
divergence  of  view  illustrates  the  importance  of  knowing  local  con¬ 
ditions  and  of  accepting  no  social  formula  without  testing  it  anew 
with  reference  to  these  conditions.  A  kernel  of  truth  remained 
unchallenged,  however;  it  was  that  the  social  worker  must  protect 
his  client  from  all  unnecessary  annoyance,  and  must  get  the  needed 
facts  from  sources  that  will  assure  this  protection. 

Like  foremen  in  large  industrial  establishments,  the  agent  of 
the  property  is  often  the  right  person  to  see,  instead  of  the  land¬ 
lord.  He  collects  the  rent  and  so  is  in  and  out  among  the  people. 
Sometimes  the  landlord  is  also  a  tenant  and  sublets.  In  that 
case  he  is  a  neighbor  and  is  to  be  dealt  with  as  such.  In  addition 
to  the  neighborhood  causes  of  bias,  he  is  likely  to  be  influenced  by 
an  additional  one  in  that  the  tenant  who  has  paid  his  rent  is  a 
model  citizen,  and  the  one  who  has  not  is  under  grave  suspicion. 
The  landlord  who  is  not  a  neighbor  can  show  this  same  bias.  An 
unfounded  complaint  made  to  a  society  to  protect  children  from 
cruelty  that  a  certain  man’s  family  and  children  were  neglected 
came  from  the  man’s  landlord  at  a  time  when  the  rent  was  unpaid. 

On  the  other  hand,  there  is  evidence  at  hand  that  landlords, 
former  ones  more  especially,  can  often  give  the  one  needed  clue 
— the  name  and  address,  or  information  about  relatives,  work  con¬ 
nections,  etc. — that  leads  to  helpful  co-operation  and  a  possible 

281 


SOCIAL  DIAGNOSIS 


solution.  In  addition  to  this,  their  account  books  are  evidence  of 
the  amount  of  the  rent,  of  the  way  in  which  it  was  paid,  and  when. 

In  writing  of  janitresses  or  caretakers,  Miss  S.  F.  Burrows  points 
out1  that  we  cannot  draw  conclusions  from  information  secured  at 
former  addresses  without  taking  into  account  the  type  of  house¬ 
keeper  interviewed,  the  differences  between  the  family  that  for¬ 
merly  lived  there  and  herself  in  nationality  and  religion,  and  the  loss 
to  her  if  the  tenant  moved  away  in  arrears  for  rent.  Despite  these 
drawbacks,  Miss  Burrows  feels  that  such  caretakers  can  give  us 
some  insight  into  “the  attitude  of  the  members  of  the  household 
toward  each  other  as  well  as  toward  their  neighbors;  the  class  of 
relatives  or  friends  frequenting  the  rooms;  their  habits  of  clean¬ 
liness,  temperance,  and  morality/'  She  would  agree  with  Mr. 
McLean,  of  course,  in  urging  the  most  rigid  analysis  of  all  evidence 
from  old  neighborhoods. 

IV.  OTHER  NEIGHBORHOOD  SOURCES 

The  local  tradesmen  are  the  most  important  Neighborhood 
Sources  not  yet  mentioned.  The  grocer,  the  druggist,  and  the 
saloon  keeper  are  the  best  known  of  these.  The  grocer  is  pre¬ 
eminently  a  neighbor,  but  his  account  books  reveal  purchasing 
habits  and  food  habits.  The  druggist's  value  is  illustrated  by 
Miss  Sears,  who  is  quoted  on  page  275.  We  should  know  the  laws 
regulating  the  sale  of  opiates,  and  realize  that  the  druggist  who 
observes  such  laws  strictly,  especially  while  they  are  still  new,  is  a 
very  unpopular  man  in  some  neighborhoods. 

In  most  foreign  neighborhoods  there  is  some  one  man  who  stands 
out  as  the  representative  member,  the  spokesman  of  the  foreign 
group.  His  position  is  not  an  official  one,  though  he  is  often  inter¬ 
ested  in  local  politics.  He  is  a  mine  of  information  about  the  family 
life  of  his  compatriots,  but  he  must  know  and  sympathize  with  the 
inquirer’s  interest  before  he  will  be  frank.  This  fellow-countryman 
need  not  always  be  a  present  or  a  former  neighbor.  In  the  smaller 
foreign  groups,  he  is  likely  to  know  any  of  his  own  people  who  are 
living  in  the  same  city. 

One  very  important  Neighborhood  Source — the  social  settle¬ 
ment — is  not  included  in  this  chapter  because  the  valuable  evi- 
1  In  one  of  the  short,  unpublished  papers  referred  to  in  the  Preface. 

282 


NEIGHBORHOOD  SOURCES 


dencethat  it  can  give  about  the  neighborhood  background  and  other 
important  matters  is  considered  under  Social  Agencies  as  Sources. 

SUMMARY  OF  THIS  CHAPTER 

1.  A  tendency  to  lean  heavily  upon  evidence  from  Neighborhood  Sources  marks 
a  low  degree  of  diagnostic  skill. 

2.  Present  neighbors  are  often  biased  witnesses,  because  they  wish  to  do  a  favor 
or  to  pay  off  a  grudge.  In  questioning  them  there  is  also  risk  of  humiliating  a  client. 

3.  Certain  difficulties  cannot  be  solved  without  the  evidence  of  present  neighbors, 
however.  These  situations  usually  center  around  the  need  of  legal  protection  or  of 
physical  protection  for  someone  whose  welfare  is  seriously  endangered. 

4.  It  is  possible  to  utilize  former  neighbors  in  a  number  of  ways  that  are  less 
hazardous  than  are  consultations  with  present  neighbors,  especially  in  cases  in 
which  other  evidence  is  contradictory  or  in  which  clues  are  not  plentiful.  In  the 
latter  case  a  former  neighborhood  will  often  supply  a  supplementary  clue. 

5.  The  evidence  of  neighbors  aside,  neighborhoods  speak  fo®  themselves,  and 
their  physical,  moral,  and  social  characteristics — those  of  t-h^(Rtse  lived  in,  of  the 
shops,  the  streets,  the  local  amusements,  the  play  facilities — should  all  be  noted. 

6.  Present  landlords  should  be  avoided  usually  by  representatives  of  any  agency 
whose  connection  with  a  tenant,  if  known,  would  be  liable  to  create  a  prejudice 
against  him. 

7.  The  local  tradesmen — the  grocer,  the  druggist,  the  saloon  keeper — are  Neigh¬ 
borhood  Sources. 

8.  In  foreign  neighborhoods  there  is  often  some  one  man  whose  co-operation  is 
valuable  because  he  stands  out  as  the  group  leader,  as  the  natural  spokesman  and 
representative  of  his  compatriots. 


283 


CHAPTER  XV 


MISCELLANEOUS  SOURCES 

THIS  review  of  outside  sources  of  information  and  their  uses 
is  nearing  its  conclusion.  One  of  the  most  important  sources 
of  all  is  the  social  agencies  themselves,  but  treatment  of  this 
source  has  been  reserved  for  the  next  chapter  for  reasons  there 
explained.  The  other  sources  to  which  no  attention  has  yet  been 
given  fall  into  three  groups:  (i)  public  departments  not  directly 
engaged  in  social  work,  (2)  business  sources  other  than  employers 
and  neighborhood  tradesmen,  (3)  fraternal  orders.  None  of  these 
requires  very  extended  notice. 

It  was  hoped  that  even  a  limited  inquiry  into  the  outside  sources 
now  being  used  by  social  agencies  would  discover  some  useful  ones 
which  were  still  quite  generally  neglected.  As  a  matter  of  fact,  a 
number  of  these  have  been  unearthed.  Every  new  source  evalu¬ 
ated  and  held  in  reserve  for  the  right  occasion  enriches  social  case 
work  and  gives  it  greater  flexibility.  There  is  crudity  everywhere 
in  the  processes  of  an  art  so  new,  but  the  only  discouraging  case 
work  practice  is  that  which  settles  back  into  a  certain  routine,  a 
certain  round  of  things  invariably  done,  without  any  fresh  thought 
or  spirit  of  adventure.  By  comparison  with  the  efforts  of  those 
who  are  less  experienced,  such  routine  work  may  seem,  on  first 
examination,  fairly  good,  but  there  is  a  blight  upon  it;  closer 
scrutiny  shows  that  no  experiments  are  being  tried,  no  established 
method  is  being  revised  or  discarded.  Work  not  half  so  good  may 
contain  far  more  promise,  therefore,  if  it  bears  marks  of  dissatis¬ 
faction  with  the  tool  and  its  manipulation. 

One  of  these  marks  is  the  habit  of  seeking  unusual  sources  of 
knowledge  and  co-operation.  Without  imagination  we  do  not  find 
even  the  obvious  source  that  has  been  overlooked.  Like  Mr. 
Deland’s  advertiser  of  carpets,1  who  realized  that  families  were 

1  Deland,  Lorin  F.:  Imagination  in  Business,  p.  43.  New  York,  Harper  and 
Brothers,  1909. 


284 


MISCELLANEOUS  SOURCES 


more  likely  to  buy  floor  coverings  when  they  moved  to  another 
house  and  then,  after  repeated  experiments  in  wrong  directions, 
discovered  that  the  one  man  who  always  knew  when  people  were 
going  to  move  was  the  moving  van  proprietor,  we  must  be  able  to 
think  of  familiar  things  in  a  fresh  and  unfamiliar  way.  The  unusual 
sources  mentioned  in  this  chapter  under  business  sources  are 
mentioned  not  so  much  for  their  value  in  themselves  as  for  the 
process  by  which  they  were  brought  to  light.  The  same  enterprise 
that,  in  the  agencies  studied,  discovered  and  used  these  will  dis¬ 
cover  and  use  others. 


I.  PUBLIC  OFFICIALS 

Educational  and  health  authorities  have  been  discussed  in  earlier 
chapters,1  and  public  charitable  and  correctional  agencies  and  in¬ 
stitutions  are  more  appropriately  considered  under  social  agencies 
than  under  miscellaneous  public  agencies. 

1.  Police.  From  one  point  of  view  the  police  seem  an  impor¬ 
tant  neighborhood  source,  so  identified  are  they  with  the  neighbor¬ 
hood  life.  Nor  are  they  infrequently  consulted.  In  two  of  the 
three  cities  studied,  they  rank  seventeenth  and  eighteenth  respec¬ 
tively  and  in  one  even  third  in  frequency  of  use. 

The  idea  has  often  been  advanced  that  the  police  forces  of  our 
cities  should  be  made  up  of  men  with  the  point  of  view  and  the 
training  of  social  workers.  Boies  in  1893  was  probably  the  first 
one  to  take  this  view,2  but  even  a  quarter  of  a  century  later  the 
actual  situation  hardly  justifies  the  classification  of  police  depart¬ 
ments  under  social  agencies,  though  advances  in  that  direction 
have  been  made,  notably  in  New  York  City,  under  the  adminis¬ 
tration  of  Police  Commissioner  Woods.  A  probation  officer  some 
of  whose  case  histories  were  studied  for  this  book  declares  that 
the  policeman  is  a  too  much  neglected  factor  in  social  endeavor, 
that  he  knows  the  families  on  his  beat  thoroughly,  and  is  very 
sensitive  to  the  critical  attitude  taken  toward  him  by  some  social 
workers;  after  his  personal  friendship  is  won,  there  is  nothing 
that  he  will  not  do.  True  enough,  but  the  attitude  thus  described 

1  See  Chapters  XI,  Schools  as  Sources,  and  X,  Medical  Sources. 

2  Boies,  Henry  M.:  Prisoners  and  Paupers,  p.  241.  New  York,  G.  P.  Putnam’s 
Sons,  1893. 


285 


SOCIAL  DIAGNOSIS 


is  not  the  professional  but  the  neighborhood  state  of  mind.  It  is 
only  in  the  capacity  of  social  witness,  of  course,  that  the  policeman 
is  here  considered,  and  even  so  the  country  as  a  whole,  not  any  one 
of  its  cities,  is  in  mind.  Often  the  policeman  holds  so  many  rela¬ 
tions,  political  and  other,  to  the  people  who  live  on  his  beat  that 
he  is  not  willing  to  tell  what  he  knows  when  the  telling  would  have 
great  social  value  and  would  be  in  no  wise  subversive  of  discipline; 
nor  is  he  always  willing  to  discover  the  things  which  it  is  his  special 
task  to  discover. 

A  worker  in  a  child-protective  agency  suggests  that,  in  cases 
where  such  personal  and  political  complications  are  likely  to  inter¬ 
fere  with  the  patrolman’s  usefulness,  it  is  often  better  to  seek 
information  through  the  sergeant  of  police.  He  is  in  line  for  pro¬ 
motion,  is  anxious  for  court  work  for  that  reason,  and,  though  still 
closely  in  touch  with  his  district,  is  no  longer  so  dependent  upon 
the  good  will  of  its  people.  The  individual  policeman  has  been 
known  to  withhold  testimony  against  a  family  whose  children  were 
neglected,  for  the  reason  that  he  was  indebted  to  them  for  a  useful 
tip  or  for  some  other  favor.  Moreover,  the  statements  of  those 
members  of  the  force  that  are  known  by  the  judge  to  be  untrust¬ 
worthy  are  likely  to  be  discounted  in  court.. 

After  these  drawbacks  are  given  due  weight,  it  is  still  not  only 
necessary  to  consult  patrolmen  in  a  good  many  instances,  but  per¬ 
fectly  possible,  often,  to  establish  an  understanding  with  them 
which  will  win  very  valuable  co-operation. 

Usually  three  men  patrol  each  beat,  one  in  the  daytime  and 
two  who  alternate  at  night.  There  is  no  record  system.  What 
each  one  knows  is  known  to  him  only,  so  that,  where  it  is  important 
to  cover  the  whole  ground,  each  one  of  the  three  must  be  seen.  It 
is  necessary  to  know  the  hours  at  which  patrolmen  and  different 
special  officers  can  be  found  at  the  police  station.  The  night 
officers  are  particularly  useful,  in  child  neglect  cases,  as  the  disor¬ 
derly  conduct  that  will  be  accepted  as  proof  of  neglect  often  takes 
place  at  night. 

In  the  search  for  runaway  boys  and  mentally  disturbed  adults 
who  have  disappeared,  it  is  necessary  to  communicate  with  the 
police  both  in  town  and  elsewhere.  The  chief  of  police  in  smaller 
places  is  consulted  a  great  deal  by  social  workers  at  a  distance, 

286 


MISCELLANEOUS  SOURCES 


who  seek  from  him  information  as  to  the  standing  of  former  and 
present  residents,  as  to  records  of  arrest,  etc.  If  it  is  possible  to 
judge  by  case  record  reading,  the  police  departments  in  these 
communities  are  giving  a  better  grade  of  social  service  than  in  the 
large  cities.  They  deal  with  many  problems  that  are  divided 
among  the  varied  agencies  of  the  large  place,  and  this  fact  alone 
develops  in  them  a  degree  of  social  experience. 

2.  Other  Officials.  The  list  of  Miscellaneous  Sources  actually 
used  in  the  2,800  cases  reviewed  shows  occasional  consultations, 
though  these  are  by  no  means  frequent,  with  the  following  state 
and  city  departments  or  officials:  State,  employment  bureau,  de¬ 
partment  of  labor,  controller,  board  of  insanity,  penal  commis¬ 
sioner.  City,  district  attorney,  city  solicitor,  assessor,  treasurer, 
sheriff,  street  inspector,  store  inspector,  superintendent  of  news¬ 
boys,  town  clerk,  chairman  of  the  board  of  supervisors. 

Courts  are  not  included  here  because,  often,  they  have  proba¬ 
tion  officers  and  other  social  workers  associated  with  them  and  are 
consulted  as  social  agencies.  More  often  still  their  official  records 
are  the  real  source,  and  these  are  considered  under  Documentary 
Sources.  When  it  is  necessary  to  consult  an  official  of  the  court 
it  will  usually  be  found  that  the  clerk  remembers  the  case  in  ques¬ 
tion  better  than  the  judge.  In  like  manner,  the  town  clerk  in 
small  communities,  or  the  official  whose  duties  correspond  to  those 
of  the  town  clerk,  is  the  one  who  knows  most  about  his  fellow 
citizens.  The  town  librarian  is  another  possible  source  of  com¬ 
munity  information,  though  he  does  not  appear  in  the  statistics 
gathered. 

Social  workers  must  remember  ^that  most  of  these  city  officials 
are  desk  men  and  take  a  desk  point  of  view.  The  impressions  that 
they  get,  aside  from  the  documentary  evidence  that  passes  through 
their  hands,  are  the  impressions  not  of  those  who  work  in  the  open 
but  of  those  who  hear  only  the  client's  stories  usually,  and  who 
accept  or  reject  these  without  the  analysis  or  the  readjustment  of 
view  that  follows  naturally  upon  frequent  home  and  neighborhood 
visiting.  Whereas  the  policeman  is  too  much  exposed  to  neigh¬ 
borhood  influences  these  others  are  not  enough  so.  It  is  often  the 
social  worker's  task  to  explain  to  them  the  modifying  circumstances 
of  an  individual  case  as  the  facts  come  to  light.  Only  in  personal 

287 


SOCIAL  DIAGNOSIS 


interviews,  where  the  desk  man  has  the  opportunity  to  explain 
his  own  point  of  view  at  length,  can  he  be  induced  to  modify  it. 
Again,  the  official  who  is  already  interested  in  a  personal  problem 
is  antagonized  by  letters  and  telephone  messages,  unless  he  has 
had  enough  experience  with  social  work  processes  to  understand 
their  details  without  careful  preliminary  explanations,  which  are 
given  much  better  face  to  face. 

The  federal  officials  most  often  consulted  are  those  in  the  bureau 
of  immigration,  postmasters,1  United  States  consuls,2  and  officials 
of  the  War  and  Navy  Departments. 

Foreign  consuls  appeared  frequently  in  the  case  records  read  for 
this  volume.  Here  are  a  few  of  the  matters  about  which  they 
were  consulted:3 

A  German  consul  in  an  American  city  was  appealed  to  about  a  young  German 
officer  who  claimed  that  he  had  been  obliged  to  1  eave  the  army  because  the  death 
of  a  relative  had  reduced  his  income.  He  asked  to  be  sent  to  New  York,  where  he 
was  sure  that  he  could  get  work  with  the  Hamburg- American  Line.  The  consul 
was  able  to  throw  some  light  on  the  young  man’s  finances  and  on  his  chances  of  get¬ 
ting  work  in  New  York. 

An  Austrian  consul  knew  the  region  from  which  a  miner,  blinded  through  his 
own  carelessness,  had  originally  come.  There  was  no  provision  for  the  blind  there 
and  the  man  had  no  family.  The  consul’s  first-hand  knowledge  of  this  Austrian 
province  determined  a  hospital  social  service  department  against  deportation  and 
in  favor  of  training  for  work  in  this  country. 

A  Greek  consul  in  one  of  our  states  undertook  to  get  information  in  another  about 
the  mother  of  a  Greek  girl  who  had  run  away  from  home  because,  as  she  claimed,  her 
mother  had  abused  her.  The  consul,  after  inquiry  by  letter,  gave  the  woman  a  very 
good  name,  but  a  social  worker,  sent  to  the  mother’s  own  community  later,  dis¬ 
covered  that  the  girl’s  charges  were  more  than  justified. 

A  Greek  consul  helped  a  widow  whose  children  were  still  in  Greece,  first  by  paying 
her  board  while  she  received  special  treatment  to  recover  the  use  of  her  arm;  second 
by  asking  his  own  sister  in  Athens  to  secure  certain  information  about  the  children. 

II.  CERTAIN  BUSINESS  SOURCES 

Employers  and  neighborhood  tradesmen4  by  no  means  exhaust 
the  list  of  business  sources  that  may  be  used  in  social  diagnosis. 

1  See  p.  336.  2  See  p.  326. 

3  These  were  all  consultations  before  August,  1914.  The  European  war  may 
have  modified  the  method  of  approach  and  the  service  procured  in  some  instances. 

4  See  Chapters  XII,  Employers  and  Other  Work  Sources,  and  XIV,  Neighbor¬ 
hood  Sources. 


288 


MISCELLANEOUS  SOURCES 


A  firm  with  whom  our  client  has  had  business  dealings  in  the  past, 
or  someone  who  is  an  authority  on  the  fluctuations  of  a  certain 
market,  or  on  a  certain  industrial  process  may  be  an  invaluable 
witness. 

Sometimes  it  happens  that  the  business  dealings  may  have  been 
of  the  most  casual  kind — the  moving  of  furniture,  its  storage,  its 
purchase  on  the  installment  plan,  the  collection  of  an  insurance 
premium,  the  delivery  of  an  express  package — but  the  details  of 
the  transaction  may  reveal  some  bit  of  evidence  that  is  all  the  more 
valuable  because  it  is  circumstantial  and  not  originally  related  to 
the  matter  at  issue. 

A  charity  organization  society  was  helping  the  drinking  wife  of  a  workman  em¬ 
ployed  in  another  city.  The  wife  was  on  probation,  and  the  husband  was  sending 
money  to  the  society  for  the  support  of  his  family.  Two  insurance  agents  who 
called  to  collect  weekly  premiums  at  the  woman’s  home  were  able  to  give  clues  that 
aided  later  in  the  protection  of  the  children.  The  relation  of  such  agents  with  the 
homes  that  they  visit  is,  of  course,  only  a  business  one;  these  men  were  not  willing 
to  have  the  information  obtained  from  them  used  as  evidence  in  court.  It  was 
treated  as  strictly  confidential. 

A  girl  who  came  to  a  dispensary  was  so  dangerously  ill  that  she  was  transferred 
to  the  city  hospital.  The  medical  diagnosis  was  obscure,  and  the  only  social  in¬ 
formation  was  her  address.  This  was  a  lodging  house  to  which  she  had  recently 
come;  the  landlady  knew  nothing  but  the  name  of  the  expressman  who  had  brought 
the  girl’s  trunk.  From  him  was  procured  an  earlier  address  and  from  that  previous 
residence  a  pertinent  history, 

A  summons  for  the  father  of  six  neglected  children  could  not  be  served  because 
the  family  had  moved,  present  residence  unknown.  The  former  landlady  was  able 
to  give  the  license  number  of  the  moving  van  that  took  their  goods,  however,  and 
through  the  police  this  number  was  traced  to  a  local  firm.  They  kept  no  record 
when  a  family  paid  for  the  moving  in  advance,  as  this  family  had,  but  they  obtained 
the  address  from  the  driver  of  the  team. 

A  charity  organization  society  over  1,100  miles  away  wrote  to  an  S.  P.  C.  C.  in 
the  interest  of  a  child  whose  mother  had  deserted  her  home  in  the  society’s  city, 
had  taken  her  little  boy  with  her,  and  was  living  with  a  man  not  her  husband.  A 
neighbor  known  to  the  S.  P.  C.  C.  was  asked  by  them  to  take  the  number  of  the 
moving  van,  if  this  couple  moved  away.  As  a  matter  of  fact,  however,  they  were 
found  in  another  city  through  the  records  of  a  sewing  machine  company  from  which 
they  had  made  an  installment  purchase.  The  father  of  the  boy  was  sent  to  this 
third  city  and  there  secured  the  legal  custody  of  his  child. 

1  An  Italian  family,  upon  its  first  application  to  a  relief  agency, 
often  claims  to  have  no  relatives  whatever.  Where  there  has  been 

289 


19 


SOCIAL  DIAGNOSIS 


a  death  in  the  family,  the  undertaker  often  knows  the  name  of  the 
male  relative  that  managed  the  funeral. 

One  visit  to  an  undertaker  in  a  large  city  brought  an  unexpected  piece  of  informa¬ 
tion.  A  middle-aged  man  with  a  young  wife  and  one  small  child  had  applied  to  a 
charity  organization  society  for  relief  and  help  in  getting  work.  As  the  background 
of  his  story  was  very  scant,  a  memorandum  was  made  of  the  name  of  the  under¬ 
taker,  in  a  neighborhood  five  miles  away,  who  had  “buried”  his  first  wife.  This 
information  had  been  volunteered,  not  sought.  The  undertaker  knew  all  about  the 
first  wife;  she  was  a  neighbor  of  his,  still  living  and  in  excellent  health.  There  had 
been  no  divorce,  her  husband  had  simply  disappeared  one  day,  but  she  had  no  desire 
to  see  again  the  man  whom  she  had  formerly  had  to  support. 

A  somewhat  unusual  use  of  a  business  source  of  information  is  the  following:  A 
hospital  social  service  department  was  interested  in  an  alcoholic  case,  a  woman 
whose  only  near  relative  was  a  daughter.  The  mother  was  unable  to  give  this 
daughter’s  address,  as  was  also  a  cousin  who  was  visited.  The  latter  knew,  how¬ 
ever,  that  she  was  engaged  to  marry  a  professional  baseball  player  whose  name  he 
was  able  to  give.  The  sporting  editor  of  a  daily  paper  supplied  an  address  at  which 
the  player  was  found. 

III.  FRATERNAL  ORDERS 

Benefit  societies  of  the  insurance  type  often  have  to  be  consulted. 
They  belong  halfway  between  references  of  a  business  and  those 
of  a  social  nature.  The  fraternal  feature  is  more  marked  in  the 
foreign  benefit  orders,  for  in  these  the  ties  of  a  common  past  are 
more  binding.  A  point  worth  remembering  is  that  the  one  who 
proposed  our  client  for  membership  in  the  order  is  usually  a  person 
well  acquainted  with  him  and  with  his  family. 

Of  the  fraternal  societies,  not  of  the  insurance  type,  the  oldest 
and  the  one  that  appeared  most  often  in  the  case  records  studied 
was  the  Masons.  This  society’s  relations  to  social  workers  may  well 
stand  for  those  of  the  whole  group  of  sources  to  which  it  belongs. 
Membership  in  the  Masonic  fraternity,  even  if  a  generation  or 
more  back,  is  a  fact  worth  knowing,  as  the  society  interests  itself 
in  the  descendants  of  members  who  died  in  good  standing.  In 
some  of  the  cases  studied,  members  not  in  good  standing  were 
helped  generously,  if  not  by  their  own  home  lodge,  then  by  one 
in  the  city  of  temporary  residence.  This  generosity  is  so  generally 
known  that  it  has  been  imposed  upon  in  the  past,  and  the  society 
has  found  it  necessary  to  establish  a  “black  list”  of  those  who  are 
making  fraudulent  claims  of  membership  and  are  begging  from  city 

290 


MISCELLANEOUS  SOURCES 


to  city.  The  best  approach  for  information  with  regard  to  a  client 
who  is  a  Mason  is  by  letter  to  the  master  of  the  particular  lodge  of 
which  he  is  or  has  been  a  member.  If  this  is  not  known,  a  letter 
to  the  grand  secretary  for  the  state  will  usually  bring  the  name  of 
the  master  of  the  particular  lodge  and  its  address.  Inquiry  of  the 
client  s  lodge  should  include  a  definite  statement  as  to  the  reasons 
for  asking  information,  give  the  possibilities  of  his  case  so  far  as 
known,  and  ask  for  advice.  Non-resident  Masons  in  need  of  assist¬ 
ance  are  usually  cared  for  by  a  local  Masonic  relief  association; 
the  order  is  not  a  relief  body,  however,  but  a  fraternal  one. 

A  hospital  social  service  department  was  interested  in  a  man  whose  arm  had  been 
disabled  by  a  fall.  A  Masonic  lodge  in  another  city  sent  assistance,  but  explained 
(through  the  local  Masonic  relief  association)  that  the  recipient  had  often  been  de¬ 
pendent  before  the  accident.  As  his  arm  got  better,  he  showed  little  inclination 
to  find  work  for  himself,  and  the  relative  and  the  Masonic  lodge  that  had  been 
helping  both  agreed  to  give  their  aid  through  an  agency  for  homeless  men  which 
tried  to  stimulate  his  powers  of  self-help. 


SUMMARY  OF  THIS  CHAPTER 

1.  The  unusual  source  newly  discovered  and  evaluated  and  then  held  in  reserve 
for  the  right  occasion  is  one  test  of  diagnostic  skill.  It  is  a  better  test  than  the 
attainment  of  a  certain  minimum  (even  of  a  fairly  high  minimum)  of  ground  in¬ 
variably  covered  in  every  case. 

2.  The  policeman’s  strong  points  as  a  source  of  information  are  his  intimate 

knowledge  of  neighborhood  standards  and  his  first-hand  witness  of  the  goings  and 
comings  within  the  neighborhood.  His  weak  points  are  his  political  and  other  rela¬ 
tions  to  the  people,  which  tend  to  make  him  as  unsatisfactory  as  any  strictly  neigh¬ 
borhood  source.  6 

3-  jf  the  policeman  is  too  much  exposed  to  neighborhood  influences,  many  public 
officials,  who  are  desk  men,  are  not  enough  so.  As  a  means  of  arriving  at  a  common 
understanding,  personal  interviews  with  them,  in  which  their  exclusively  desk  point 
of  view  can  be  supplemented,  are  far  better  than  letters. 

4-  Among  the  business  sources  cited  in  this  chapter  are  some  implying  relatively 
s  ig  t  contacts,  such  as  insurance  collecting,  the  moving  of  furniture  or  trunks,  the 
sale  of  a  sewing  machine,  etc.  These  are  mentioned,  not  because  they  are  frequently 
of  value,  but  because  they  illustrate  the  process  by  which  an  item  of  circumstantial 
evidence  may  be  so  used  as  to  uncover  important  data. 

5-  Benefit  societies  of  the  insurance  type  have  more  marked  fraternal  features 
m  the  foreign  groups.  The  one  who  proposed  a  given  person  for  membership  in 
such  an  order  is  frequently  well  acquainted  with  him  and  with  his  family. 


291 


CHAPTER  XVI 

I  .  ,  4* 

SOCIAL  AGENCIES  AS  SOURCES 

WITH  some  of  us  the  team  sense,  which  is  the  psycho¬ 
logical  basis  of  co-operation  in  social  work,  never  ex¬ 
tends  beyond  a  rather  mechanical  and  listless  “  belong¬ 
ing”;  with  others  it  develops  and  attunes  every  faculty.  The 
team,  according  to  Joseph  Lee,  “is  created  by  assuming  that  it 
exists  and  acting  boldly  out  from  that  assumption.  It  grows  as  its 
members  have  power  to  imagine  it  and  faith  to  maintain,  and 
act  upon,  the  reality  of  that  which  they  have  imagined.”1  All 
co-operation  is  primarily  an  act  of  faith.  It  implies  vision,  trust, 
and  a  common  goal. 

Though  this  theme  is  an  inspiring  one,  which  invites  digression, 
its  consideration  here  must  be  confined  to  its  relation  to  social 
diagnosis. 

The  writer  was  at  one  time  chairman  of  an  informal  committee 
of  charity  organization  workers  which  attempted  to  give  advice 
by  correspondence  to  colleagues  in  widely  scattered  communities. 
One  such  fellow  worker,  who  had  just  become  executive  secretary 
of  a  society  long  established  but  with  a  none  too  prosperous  past, 
wrote  for  suggestions  about  co-operation  and  added,  “The  investi¬ 
gations  made  by  this  society  are  very  good  indeed,  but  there  is 
no  co-operation  whatever  among  the  social  agencies  of  the  com¬ 
munity.”  As  gently  as  possible,  an  attempt  was  made  to  discover 
the  diagnostic  habits  of  this  organization,  which  had  so  completely 
failed  to  establish  relations  with  its  social  environment.  Inquiries 
were  fruitless.  The  reply  came  back  that  their  investigations  were 
“all  right,”  and  that  what  was  wanted  was  light  on  an  entirely 
different  subject. 

Case  work  co-operation  of  some  sort  is  possible,  perhaps,  with- 

1  Lee,  Joseph:  Play  in  Education,  p.  339.  New  York,  The  Macmillan  Co., 
1915. 


292 


SOCIAL  AGENCIES  AS  SOURCES 


out  intelligent  diagnosis,  and  a  very  poor  sort  of  diagnosis  is  pos¬ 
sible  without  the  co-operation  of  case  workers  in  other  social 
agencies,  but,  wherever  the  processes  of  co-operation  and  of  inves¬ 
tigation  have  progressed  far  enough  to  have  genuine  social  better¬ 
ment  for  their  aim,  they  might  almost  be  described  as  one  piece 
of  goods.  In  its  relations  with  client,  client's  family,  and  outside 
sources,  diagnosis  with  a  social  aim  is  a  fine  exercise  in  working 
together.  Gross  is  quoted  at  the  beginning  of  this  book  as  saying, 
“  The  trained  man  understands  how  little  the  mind  of  an  individual 
can  grasp,  and  how  many  must  co-operate  in  order  to  explain  the 
very  simplest  things."  Working  together  in  order  to  understand 
and  achieve  is  always  a  more  fruitful  process  than  co-operating 
in  order  to  co-operate. 

There  seem  to  have  been  in  this  country  four  stages  of  develop¬ 
ment  from  competition  to  co-operation  in  social  work.  Needless 
to  add,  all  four  of  these  stages  exist  today — just  as  the  phrenolo¬ 
gists  still  exist  (and  prosper  apparently)  in  the  very  communities 
that  have  given  to  the  world  some  of  the  important  discoveries  of 
experimental  psychology. 

(1)  The  first  or  competitive  stage  was  chaos.  Some  of  the 
charitable  conditions  of  that  earlier  time  actually  created  a  demand 
for  child  inmates  among  certain  groups  of  institutions,  and  stout 
objection  to  any  reform  that  “cut  down  their  figures"  extended 
to  many  charities  besides  those  for  children.  The  absence  of  com¬ 
mon  understandings,  of  any  unwritten  code  governing  the  behav¬ 
ior  of  social  practitioners  to  one  another,  was  another  ugly  char¬ 
acteristic  of  this  competitive  period  in  social  case  work. 

(2)  The  earliest  approaches  to  social  co-operation  were  like  the 
earliest  approaches  to  social  diagnosis — they  were  made  in  vacuo. 
The  competitive  period  was  succeeded  by  a  series  of  extremely 
awkward  attempts — most  of  them  unrelated — to  replace  competi¬ 
tion  by  co-operation.  As  a  result  of  this  awkwardness,  the  latter 
word  came  to  have  some  unpleasant  associations.  Miss  Birtwell 
has  noted  1  that  at  this  stage  our  facts  were  gathered  together, 
then  our  plans  were  made,  and  later  the  investigating  agency 
appealed  for  co-operation  “wherever  there  was  promise  of  support 
for  those  particular  plans.  We  took  to  heart,"  she  adds,  “  the  mild 

1  In  one  of  the  short,  unpublished  papers  referred  to  in  the  Preface. 

293 


SOCIAL  DIAGNOSIS 


reproach  of  a  Catholic  priest,  who  once  said  to  one  of  our  young 
workers:  ‘You  make  your  investigation  and  form  your  plans,  and 
then  assign  me  a  part  in  them;  but  I  want  to  come  in  at  the  very 
beginning,  where  my  people  are  concerned/”  The  method  thus 
complained  of  was  characteristic  of  the  period  of  co-operation 
in  vacuo. 

(3)  Further  attempts  to  conquer  chaos  were  by  a  routine  division 
of  cases  on  the  basis  of  territory,  of  nature  of  need,  etc.  Here  belong 
also  the  beginnings  of  any  systematiclnterchange  of  information 
through  registration  bureaus,  confidential  exchanges,  or  social 
service  exchanges,  as  they  have  been  called  at  various  times  and 
in  various  places. 1  These  emphasized  the  avoidance  of  duplication, 
at  first,  but  now  regard  elimination  of  waste  as  a  by-product  of 
more  constructive  gains.  Some  of  the  agreements  and  reforms  of 
this  period  have  led  to  excellent  results,  and  co-operative  develop¬ 
ment  would  have  been  impossible  without  them,  but  traces  of  their 
inauguration  as  found  in  the  case  records  of  organizations  that 
made  the  mistake  of  leaning  too  heavily  upon  the  new  devices 
suggest  that  all  such  arrangements  have  their  dangers.  Through 
unimaginative  or  selfish  use,  they  may  develop  the  characteristics 
of  those  agreements  in  the  business  world  which  ignore  the  interests 
of  the  consumer — with  us  the  client.  The  social  diagnostician 
must,  of  course,  consider  his  relations  with  his  client  as  of  even 
greater  importance  than  his  relations  with  the  social  agencies  of 
his  community.  To  accept  every  statement  of  a  social  agency  at 
its  face  value,  to  regard  every  professional  opinion  as  equal  in 
specific  gravity  to  every  other,  may  be  a  convenience  when  the 
confidential  exchange  first  becomes  available;  this  acquiescence 
may  save  trouble  to  the  consultant  and  to  the  agency  consulted, 
but  the  assumption  can  do  the  social  case  worker’s  clients  grave 
injustice  nevertheless. 

Just  after  “joint  traffic  agreements”  among  social  agencies  have 
become  popular  in  a  community,  one  may  expect  to  find  in  its 
case  records  the  conclusions  of  co-operating  agencies  accepted 
without  any  of  the  data  upon  which  they  are  based,  may  expect  to 
see  recorded  many  duplicate  descriptions  of  the  present  situation 
of  clients,  and  may  observe  the  gossip  and  guesses  of  workers  with 

1  Described  p.  303  sq. 

294 


SOCIAL  AGENCIES  AS  SOURCES 


differing  standards  promoted  to  the  dignity  of  "an  investigation/' 
All  of  this  is  part  of  the  price  of  progress,  probably,  but  no  time 
should  be  lost  in  progressing  beyond  it.  It  is  distressing  to  find 
unfavorable  data  overemphasized.  Perhaps  records  of  arrest  and 
imprisonment  were  not  open  to  the  social  agencies  previously; 
when  they  became  accessible  through  the  exchange  it  was  easy  at 
first  to  put  too  much  emphasis  upon  the  mere  fact  of  a  previous 
arrest,  without  seeking  the  details  that  would  have  explained 
its  possibly  accidental  nature.  Or  perhaps  a  previous  application 
for  relief  had  come  to  light  automatically  under  a  new  plan  of 
interchange  between  agencies,  though  the  client  had  denied  having 
made  any  previous  application  for  help.  Is  he  a  fraud?  Not 
necessarily.  Many  harmless  men  and  women  might  be  given  a 
bad  name  in  this  fashion,  or,  to  take  the  opposite  possibility,  a 
client’s  record  might  bristle  with  respectable  social  authorities  and 
endorsers,  yet  contain  few  facts  and  fewer  insights.  What  is 
needed — and  this  need,  be  it  remembered,  cannot  be  well  met  with¬ 
out  complete  interchange  of  information  among  agencies — is  a 
sense  of  the  main  drift  of  a  client’s  life,  a  summing  up  at  some  one 
stage,  preferably  an  early  one  in  each  case,  of  the  assets  and  liabili¬ 
ties  in  character  and  environment  with  which  social  agencies  have 
to  deal  if  they  would  win  their  way  to  a  helpful  result.  Variations 
in  points  of  view,  provided  that  each  is  based  upon  a  real  experi¬ 
ence,  help  us  to  think.  We  are  most  helped,  in  fact,  by  the  ex¬ 
perience  of  the  agency  least  like  our  own,  but  the  right  of  each  to 
compare  its  experience  with  other  experiences  and  to  reason  about 
it  should  not  be  abrogated.  When  it  is,  we  encounter  the  chief 
danger  of  the  period  of  joint  traffic  agreements. 

(4)  These  frankly  stated  drawbacks  are  no  argument,  however, 
for  a  return  to  chaos.  They  urge  us,  rather,  to  push  on  toward  the 
logical  next  step  in  co-operation — toward  the  kind  of  honestly 
evaluated  sharing,  toward  the  increased  social  responsibility,  which 
not  only  avoids  mischievous  interference  with  the  client’s  best 
interests,  but  can  be  of  inestimable  value  in  furthering  them. 

Devices  have  their  place  in  such  a  development;  understandings 
of  a  formal  sort  have  their  place.  At  one  stage  it  may  be  neces¬ 
sary  to  have  a  more  or  less  arbitrary  division  of  work.  For  ex¬ 
ample,  it  may  be  wise  to  have  an  agreement  between  the  charity 

295 


SOCIAL  DIAGNOSIS 


organization  society  and  the  visiting  nurse  association  that  the 
nurses  will  turn  “family  problems'’  over  to  the  family  agency,  and 
that  the  family  agency  will  turn  over  all  “health  matters”  to  the 
nursing  agency.  It  is  illogical  to  assume  that  there  is  any  clear 
line  of  demarcation  between  these  two  things,  but  some  such 
division  may  be  a  working  necessity. 

A  truer  co-operation  will  soon  cut  a  gateway  in  the  fence  thus 
put  up,  however,  and  will  be  sure  to  find  in  addition  a  section  of 
ground  which  must  be  occupied  in  common,  if  the  best  work  is  to 
be  done.  When  this  more  highly  developed  stage  in  working 
together  is  reached,  the  understandings  growing  out  of  it  will  defy 
statement  in  a  bald  formula.1 

Co-operation  based  on  responsibility  for  the  result  of  our  social 
acts,  co-operation  advanced  by  sound  and  thorough  professional 
training,  fostered  by  good  will,  by  social  zeal,  and  by  unhampered 
freedom  of  discovery,  leads  us  away  from  “understandings”  and 
into  a  daily  deepening  understanding.  This  latter  is  a  matter  of 
the  spirit.  Freedom  to  learn,  to  grow,  and  to  serve  is  fostered  by 
co-operation  of  the  spirit.  This  is  the  fourth  and  highest  period 
of  social  co-operation,  for  which  the  other  periods  are  only  pre¬ 
paratory. 

I.  TWO  DISTINCT  FUNCTIONS  OF  SOCIAL  AGENCY  TESTIMONY 

Returning  to  the  statistics  of  outside  sources  once  more  and  for 

the  last  time,  we  find  that,  even  when  the  medical,  social,  and  school 

sources  considered  in  other  chapters  are  excluded  from  our  total  of 

social  agencies,  there  remains  a  larger  number  of  consultations  with 

this  latter  group  than  with  any  other.  Relatives  (next  in  order  of 

frequency)  were  consulted  1,187  times,  whereas  public  and  private 

1  My  apple  trees  will  never  get  across 
And  eat  the  cones  under  his  pines,  I  tell  him. 

He  only  says,  “Good  fences  make  good  neighbors.” 

Spring  is  the  mischief  in  me,  and  I  wonder 
If  I  could  put  a  notion  in  his  head: 

“Why  do  they  make  good  neighbors?  Isn’t  it 
Where  there  are  cows?  But  here  there  are  no  cows. 

Before  I  built  a  wall  I’d  ask  to  know 
What  I  was  walling  in  or  walling  out. 

And  to  whom  I  was  like  to  give  offense. 

Something  there  is  that  doesn’t  love  a  wall, 

That  wants  it  down.” — Robert  Frost  in  North  of  Boston.  London,  David 
Nutt,  1914. 


296 


SOCIAL  AGENCIES  AS  SOURCES 

social  agencies — the  deductions  just  named  having  been  made — 
were  consulted  2,243  times,  or,  if  we  includjb  church  sources,  2,748 
times.  If  the  plan  of  presentation  adopted  for  outside  sources 
had  been  followed  strictly,  social  agencies  would  have  been  pre¬ 
sented  first  of  all.  But,  as  sources,  these  agencies  seem  to  belong 
upon  another  plane.  In  order  to  emphasise  this  difference,  they 
have  been  reserved  for  separate  treatment  at  this  much  later  stage. 

Somewhat  different  tests  must  be  applied  to  the  evidence  given 
by  social  agencies  to  social  agencies  from  those  applied  to  the  state¬ 
ments  of  any  other  outside  sources:  first,  because  the  relation  that 
these  organizations  have  held  to  a  client  is  in  many  respects  similar 
to  the  relation  now  held  by  the  inquirer;  and  second,  because  of 
the  variety  both  of  the  tasks  that  social  organizations  perform  and 
of  the  attitudes  that  they  at  present  take  toward  the  processes  lead¬ 
ing  to  diagnosis.  The  variety  of  their  tasks  is  shown  by  Table  5, 
on  the  next  page,  and  the  nature  of  their  relation  to  their  clients 
brings  us  to  the  most  important  distinction  to  be  made  in  evaluat¬ 
ing  social  agency  testimony. 

This  distinction  is  based  upon  the  fact  that  social  agencies  can 
be  called  upon  to  fulfill  two  different  functions  as  witnesses: 

1.  To  Supply  Data  from  Their  Own  Experience.  They  may 
have  had  a  social  experience  of  their  own  with  a  client,  and 
we  may  need  to  know  that  experience.  Even  when  the  ser¬ 
vice  undertaken  for  him  was  quite  different  from  that  which 
we  ourselves  are  about  to  attempt,  it  may  have  fulfilled  all  the 
difficult  conditions  of  an  “investigation  by  experiment”;1  in  that 
case,  it  may  help  us  to  know  the  client's  reactions  and  may  give 
us  a  key  to  certain  of  his  personal  characteristics.  Social  agencies 
are  often  at  their  very  best  as  witnesses,  when  they  are  reporting, 
without  bias,  a  first-hand  experience  of  this  kind — an  experience 
acquired  in  the  course  of  treatment.  Of  course,  the  better  they 
understand  their  client's  background,  the  more  intelligent  will  be 
their  interpretation  of  this  experience. 

Institutions  for  adults  and  for  children  frequently  supply  just 
this  experience  type  of  data.  They  have  the  advantage,  when  they 
are  not  too  large,  of  being  able  to  control  the  conditions  under 
which  their  observations  are  made  far  better  than  these  can  be 

1  See  reference  to  this  term  on  p.  86. 

297 


SOCIAL  DIAGNOSIS 


TABLE  5. — SOCIAL  AGENCIES  (EXCLUSIVE  OF  HEALTH  AND  SCHOOL 
AGENCIES)  USED  AS  SOURCES  BY  56  AGENCIES  IN  2,800  CASES 


Type  of  social  agency 

Consultations 

Private  agencies 

Family  agencies 

Charity  organization  societies 

Foreign  relief  societies 

Other  relief  societies 

Total 

Homes  for  adults 

Children’s  agencies 

Homes  for  children 

Societies  for  the  prevention  of  cruelty  to  children 

Children’s  aid  societies 

Day  nurseries 

Total 

Settlements 

Unclassified 

645 

92 

219 

956 

48 

143 

122 

1 18 

47 

430 

1 19 

204 

Total  for  private  social  agencies 

i»757 

Public  agencies 

Charities  departments  (including  public  outdoor  relief) 

Adult  probation  departments 

Juvenile  probation  departments 

Municipal  lodging  houses 

Almshouses 

Unclassified 

275 

81 

72 

6 

3i 

21 

Total  for  public  social  agencies 

486 

Total  for  public  and  private  social  agencies 

2,243 

To  which,  for  the  purposes  of  this  study,  may  be  added  the  following  church  sources: 


Type  of  source 

Consultations 

Clergymen 

Fellow  church  members 

Church  visitors 

Sunday  school  teachers 

345 

IOI 

35 

24 

Total 

505 

controlled  by  the  society  or  department  engaged  in  field  work  only. 
They  have  the  corresponding  disadvantage,  however,  of  a  more 
rigid  and  artificial  standard  of  measure.  In  the  freer  give  and  take 
of  the  field,  an  artificial  standard  is  more  easily  corrected. 

298 


SOCIAL  AGENCIES  AS  SOURCES 


Plenty  of  evidence  is  at  hand  that,  when  case  workers  can  see  the  asylum  official 
who  knows  their  client,  they  get  valuable  data  as  to  the  client’s  personal  habits. 
The  temporary  homes  utilized  by  children’s  agencies  during  a  period  of  observation 
(investigation  by  experiment)  are  also  useful  aids  in  diagnosis. 

Children’s  institutions  that  are  excellent  witnesses  as  to  their  own  experiences 
with  inmates  may  still  have  only  the  vaguest  of  extra-mural  data  about  them. 
They  may  admit  them,  discharge  them,  send  them  home  temporarily  at  vacation 
time,  and  place  them  permanently  with  relatives  or  with  strangers  on  knowledge 
that  would  be  regarded  as  inadequate  by  any  humane  person  who  was  seeking  a 
home  for  a  stray  cat  or  dog.  It  follows,  of  course,  that  institutions  of  the  type  that 
Miss  Florence  L.  Lattimore  describes  in  her  study  of  Pittsburgh  are  not  competent 
witnesses  as  to  family  conditions  either  past  or  present.  Nor  is  their  investigation 
of  placing-out  homes  any  better.  In  1907,  the  date  of  Miss  Lattimore’s  study,  one 
of  the  largest  homes  in  Pittsburgh  allowed  children  to  be  taken  out  “by  any  woman 
of  respectable  appearance  who  applied  at  the  institution,  filled  out  a  blank,  and 
waited  for  the  child  to  be  dressed.”  1 

Even  in  our  estimate  of  an  institution's  intra-mural  testimony 
the  point  of  view  of  the  institution  witness  must  be  taken  into 
account.  In  fact,  the  personal  point  of  view  must  be  probed  for 
and  allowed  for  everywhere.  One  amusing  instance  of  this  ap¬ 
pears  in  a  medical-social  record: 

A  temporary  home  for  working  women  was  asked  to  report  upon  the  conduct  of  a 
certain  girl.  The  home  replied  that  she  was  troublesome,  unruly,  and  hard  to  con¬ 
trol.  When  asked  for  detailed  examples  of  her  behavior,  they  wrote  as  follows:  “We 
told  Mary  that  she  could  not  crochet  in  this  house  on  Sunday.  We  had  to  speak 
a  second  time  about  this  and  send  her  to  her  room.  Later,  we  found  her  disobeying 
upstairs.  We  do  not  allow  gaiety  of  any  sort  in  this  house  on  Sunday,  not  even 
light  music.  You  know  we  must  keep  up  a  certain  standard.” 

A  very  different  point  of  view — one  that  is  also  based  largely  on 
experience,  but  upon  experience  of  a  more  flexible  kind — is  that 
supplied  by  the  social  settlement.  The  settlement  thinks  instinc¬ 
tively  in  terms  of  neighborhood  reactions.  This  is  a  type  of  evi¬ 
dence  so  little  known  to  numbers  of  case  workers  that  they  do  not 
consciously  seek  it,  as  they  should,  or  recognize  its  absence.2 

A  head  worker  in  a  settlement,  who  had  formerly  been  for  a  year  in  a  charity 
organization  society,  writes,  in  reply  to  a  question  about  changes  in  her  point  of 

1  “  Pittsburgh  as  a  Foster  Mother,”  in  the  Pittsburgh  District,  Civic  Frontage, 
p.  348. 

2  For  a  good  illustration  of  the  type  of  neighborhood  evidence  that  a  settlement 
worker  of  experience  is  able  to  give,  see  the  descriptions  of  foreign  neighborhoods  in 
Boston  in  Robert  A.  Woods’  Americans  in  Process.  Boston,  Houghton,  Mifflin, 
and  Co.,  1902. 


299 


SOCIAL  DIAGNOSIS 


view:  “The  settlement  worker  is  continually  gauging  cause  and  effect  in  neighbor¬ 
hood  reactions,  and  by  continuous  experimenting  in  lines  of  action  tending  toward 
a  fuller  citizenship  comes  to  develop  a  sort  of  intuitive  sense  of  the  practicability 
of  plans.  Because  of  this  on  the  part  of  the  settlement  worker  and  the  training  in 
analysis  and  deduction  on  the  part  of  the  charity  organization  society  worker,  the 
two  should  work  together  closely — far  more  closely  than  they  do. 

“From  the  settlement  I  have  gained  that  subtle,  interpretative  method  of  deal¬ 
ing  with  facts  which  I  believe  can  only  come  by  steeping  one’s  self  in  the  standards, 
manners,  and  customs  of  races,  and  by  entering  into  the  community  life  of  a  neigh¬ 
borhood.  By  so  doing  one  becomes  sensitive  to  the  varying  tendencies  of  a  district, 
and  hence  one  comes  to  interpret  the  lives  of  individuals  with  all  the  gradations  of 
shading  which  make  fact  true.  Had  1  entered  as  fully  into  the  lives  of  the  working 
people  when  in  charity  organization  work  as  I  have  the  past  two  years,  I  know  1 
could  have  done  much  better  in  my  charity  organization  contacts.” 

To  still  another  group  of  sources,  to  the  churches,  social  case 
workers  may  turn  for  personal  experience  more  freely  than  for 
objective  data.  The  degree  and  variety  of  contact  with  parish¬ 
ioners  are  very  diverse,  however,  in  the  different  religious  denomina¬ 
tions  and  in  the  churches  for  different  nationalities.  La  pastor  or 
priest  of  the  foreign  community  in  an  American  city  is  often  the 
one  to  whom  members  of  the  community  most  naturally  turn  for 
advice  in  temporal  matters  also — for  the  interpreting  of  letters  and 
for  a  variety  of  other  services,  each  of  which  gives  him  added 
insight  into  the  daily  lives  of  his  people.  Parishes  are  sometimes 
so  large  and  their  clergy  so  overburdened  that  this  ceases  to  be 
true,  but  in  smaller  communities  it  often  holds  true  of  both  the 
foreign  and  the  native  American  clergy.  } 

In  court  work,  both  clergymen  and  settlement  workers  hesitate 
to  give  the  testimony  that  they  have  to  give,  even  when  this  would 
substantially  aid  in  assuring  a  much  desired  result.  The  ground 
of  their  hesitation  is  the  possibility  of  estrangement  in  future  re¬ 
lations  with  the  families  involved.  Social  workers  who  are  eager 
to  bring  about  a  certain  beneficent  result — The  protection  of  chil¬ 
dren  from  neglect,  the  punishment  of  a  deserter,  etc. — must  learn 
to  respect  this  point  of  view,  and  to  protect  the  parish  and  neigh¬ 
borhood  representative  from  involvement,  whenever  this  is  possible. 

Like  the  judge,  the  clergyman  leans  to  a  too  great  faith  in  con¬ 
version  on  the  spot.  In  fact,  the  latter  often  takes  a  deliberately 
optimistic  view  which  impairs  his  value  as  a  witness  in  court  and 
out. 


300 


SOCIAL  AGENCIES  AS  SOURCES 


In  churches  which  employ  a  pastor’s  assistant,  deaconess,  or 
church  visitor,  this  worker  often  knows  more  of  the  things  that  the 
case  worker  seeks  information  about  than  the  minister  does. 

2.  To  Supply  the  Results  of  Their  Inquiries.  There  is  a  second 
function  of  social  agencies  as  witnesses ;  namely,  to  supply  those  ob¬ 
jective  data  of  a  fundamental  sort  about  clients  which  seldom 
change.  Gathered  originally  by  a  particular  organization  for  its 
own  purposes,  these  facts  may,  if  collected  carefully  in  the  first 
place,  serve  equally  well,  and  with  substantial  economy  of  time 
and  effort,  the  purposes  of  a  second  organization.  A  more  im¬ 
portant  saving,  even,  is  the  wear  and  tear  to  the  sensibilities  of  a 
client  who  might  otherwise  be  harassed  by  needless  questioning.1 

It  will  help  us  to  evaluate  the  evidence  of  social  agencies  more 
justly  if  we  can  keep  quite  distinct  in  our  own  minds  these  two 
functions  of  theirs  as  witnesses.  In  their  testimony  from  personal 
experience  they  are  witnesses  of  their  own  knowledge;  in  testimony 
based  upon  data  that  they  have  gathered  they  are  often  witnesses 
to  matters  of  hearsay.  Even  in  this  second  capacity,  they  have 
the  advantage  sometimes,  though  not  always,  of  a  certain  skill  in 
the  weighing  and  testing  of  evidence.  If  their  items  of  outside 
evidence  have  been  recorded  and  duly  credited  to  their  sources 
at  the  time  that  they  were  gathered  with  sufficient  fullness  and 
accuracy  to  make  them  clear,  and  if  the  written  record  is  always 
consulted  before  reporting  to  another  agency,  the  danger  of  error 
is  materially  reduced.  Danger  of  error  in  the  original  observation 
remains,  however,  and  no  one  agency  is  ever  an  equally  good  judge 
of  all  kinds  of  data.  Agencies  that  habitually  neglect  certain  ob¬ 
servations  may  be  very  keen  about  certain  others.  Such  differ¬ 
ences  can  be  discovered  by  practical  experience  only.  The  par¬ 
ticular  type  of  social  work  engaged  in,  with  its  natural  limitations, 
is  one  guide;  the  history  not  only  of  the  individual  agency  but  of 
the  form  of  effort  of  which  it  is  a  part  is  another;  the  past  relations 
of  the  given  agency  to  the  one  seeking  information  is  still  another; 
but  the  most  important  factor  of  all  is  the  native  ability  and  pro¬ 
fessional  equipment  of  the  individual  case  worker  who  made  the 
original  observation  or  who  represents  the  agency  as  witness,  and 
this  is  a  changing  factor. 

1  See  also  the  discussion  of  duplicate  investigations  on  p.  3 1 1 . 

301 


SOCIAL  DIAGNOSIS 


A  case  worker  who  removes  from  one  city  to  another  must  revise  all  his  standards 
of  measure  of  social  agency  testimony.  A  charity  organization  society  or  associated 
charities,  for  example,  is  usually  an  agency  that  thinks  of  and  knows  a  family  as 
a  whole.  Relatively  speaking,  it  has  an  unusually  clear  idea  of  the  family  histories 
and  background  of  its  clients,  is  well  grounded  in  the  habit  of  conferring  with  rela¬ 
tives,  health  agencies,  former  employers,  schools,  and  the  social  agencies  interested. 
It  is  not  so  strong  in  ability  to  gauge  neighborhood  influences;  it  too  often  neglects 
to  individualize  each  growing  child  in  the  family;  it  sometimes  emphasizes  health 
and  self-support  at  the  expense  of  less  measurable  but  very  important  social  gains. 
But  in  certain  cities  the  societies  bearing  the  name  of  charity  organization  society 
or  of  associated  charities  are  only  rudderless,  small-dole  agencies,  operating  without 
plan  or  purpose.  Obviously,  it  is  necessary  to  look  beyond  the  name  and  the 
avowed  objects  of  a  society  in  accepting  its  testimony. 

A  case  worker  may  have  been  well  trained,  but  may  be  employed  by  an  agency 
under  conditions  that  make  it  impossible  for  him  to  do  trained  work.  These  con¬ 
ditions  limit  his  competence  as  a  witness,  of  course.  Some  public  departments, 
for  instance,  investigate  chiefly  with  reference  to  the  question  of  ability  or  inability 
to  reimburse  the  state,  or  with  reference  to  legal  settlement.  Others  have  rules 
that  so  many  references — three  or  four — are  to  be  consulted.  Limitations  of  this 
order  must  be  known  and  allowed  for. 

A  radical  change  of  management  in  an  agency  often  makes  it  necessary  to  note 
whether  a  particular  investigation,  together  with  the  inferences  and  plan  of  treat¬ 
ment  drawn  from  it,  was  made  before  the  change  or  after.  One  of  the  case  readers 
for  this  volume  spent  two  months  in  a  society  to  protect  children  from  cruelty  in 
which  there  had  been  a  change  of  management.  After  reading  a  large  number  of  its 
records,  she  wrote: 

“  Even  those  cases  in  which  only  one  or  two  or  three  interviews  are  thought  to  be 
necessary  show  an  absolutely  new  way  of  approach  since  the  change.  I  think  I 
mentioned  before  that,  under  the  old  regime,  unless  the  evidence  of  the  investi¬ 
gator’s  eyes,  backed  up,  perhaps,  by  a  policeman  or  a  neighbor,  showed  obvious 
neglect,  the  entry  ‘Nothing  for  us  to  do’  was  by  no  means  uncommon.  I  have  not 
found  one  case,  under  the  new  regime,  where  this  sentiment  is  expressed  in  letter  or 
in  spirit.  There  is  always  something  for  the  S.  P.  C.  C.  to  do,  though  this  is  not 
always  taking  the  case  into  court.” 

This  last  illustration  might  also  point  the  moral  that  agencies 
skilled  in  the  gathering  and  recording  of  objective  data  are  usually 
the  ones  most  likely  to  continue  treatment  long  enough  to  gather 
also  a  rich  store  of  personal  experiences.  This  is  not  always  true, 
however.  Resourceless  treatment,  together  with  inability  to 
recognize  the  significance  of  reactions  to  treatment,  may  follow  a 
fairly  good  social  diagnosis.  It  should  be  repeated,  therefore, 
that  the  two  types  of  evidence — as  to  actual,  first-hand  experiences 
with  clients,  and  as  to  objective  data  gathered  outside  about  them 

302 


SOCIAL  AGENCIES  AS  SOURCES 


— must  be  distinguished,  and  that  from  each  social  agency  must 
be  had  the  type  of  witness  that  it  is  best  able  to  give.  Social 
agencies  are  not  what  Francis  H.  McLean  calls  a  “ single-headed” 
source.1  They  are  so  far  from  being  this  that  they  presented,  in 
the  material  studied  for  this  book,  examples  of  the  very  best  and 
of  the  very  worst  social  reporting. 

With  the  increasing  activity  of  social  organizations  and  with 
their  marked  tendency  toward  specialization,  has  come  a  new  need 
of  some  systematic  exchange  of  information.  This  has  become  a 
prime  necessity,  if  only  to  fix  responsibility  for  social  treatment, 
though  it  has  many  other  advantages.  As  we  have  seen  in  the 
chapter  on  The  First  Interview,  the  first  step,  upon  receipt  of  an 
application  from  a  new  client,  is  to  discover  what  other  social 
agencies,  if  any,  are  acquainted  with  him.  This  discovery  is 
facilitated  by  the  regular  exchange  of  information  among  agencies, 
or,  better  still,  by  an  exchange  of  the  identifying  data  which  will 
lead  us  to  sources  of  information.  Very  easily  and  conveniently 
these  identifying  memoranda  lead  to  an  exchange  of  information 
when  it  is  needed  and  not  otherwise. 

II.  THE  CONFIDENTIAL  EXCHANGE 

Some  years  ago  the  writer  had  occasion  to  consult  an  oculist 
in  a  strange  city.  He  proved  very  skilful,  so  that  when  she  re¬ 
moved  her  home  from  Philadelphia  to  New  York  and  needed  to 
choose  another  regular  oculist,  she  asked  the  advice  of  this  one. 
Upon  her  first  visit  to  the  New  York  practitioner  thus  selected, 
she  tried  to  give  the  history  of  former  eye  treatments,  first  in  her 
old  home,  then  in  the  city  only  visited,  and  so  on,  making  a  sincere 
effort  to  do  this  as  accurately  as  she  could.  But  the  new  doctor 
received  these  communications  with  an  air  of  skepticism.  It 
appeared  that  he  had  been  supplied  with  more  trustworthy  data 
already;  the  specialist  who  had  recommended  him  had  sent  him  a 
detailed  statement  of  the  Philadelphia  prescriptions,  and  of  his 
own  findings  and  prescriptions.  These  were  more  truthful  than 
the  oral  witness  of  the  patient  for  two  reasons:  they  were  taken 
from  memoranda  made  at  the  time,  and,  more  important,  they 
were  taken  from  memoranda  made  by  expert  refractionists. 

1  See  p.  175. 

303 


SOCIAL  DIAGNOSIS 


Such  communication  direct  from  practitioner  to  practitioner 
greatly  reduces  the  percentage  of  error  in  every  profession,  and 
upon  the  need  of  some  such  direct  interchange  of  experiences  in 
social  work  is  based  a  system  now  widely  adopted,  especially  in  our 
larger  cities,  and  already  referred  to  in  these  pages  more  than  once. 
It  was  known  first  as  the  “registration  bureau”  and  later  as  the 
“confidential  exchange,”  or  the  “social  service  exchange.”  Its 
use  brings  other  minor  advantages,  such  as  a  checking  of  the  ten¬ 
dency  (not  confined  to  the  clients  of  social  agencies)  to  run  around 
from  adviser  to  adviser.  Doctors,  lawyers,  architects,  and  many 
other  professional  men,  probably,  know  the  type  of  nervous  in¬ 
decision,  of  speculative  fever,  of  which  such  running  around  is  only 
a  symptom. 

The  Confidential  Exchange  was  devised  by  the  charity  organi¬ 
zation  societies  and  is  still  financially  supported  or  administered  or 
both  by  these  societies  in  most  places^  Better  diagnosis,  better 
treatment,  better  understandings  among  agencies,  are  its  out¬ 
standing  achievements,  but  incidentally  it  has  reduced  duplica¬ 
tion  of  effort,  has  increased  the  sense  of  responsibility  of  the  social 
agency  definitely  in  charge  of  the  individual  case,  and  has  been, 
moreover,  a  real  economy.  Its  advantages  are  not  confined  to  the 
processes  of  social  diagnosis,  for,  long  after  treatment  has  begun, 
an  inquiry  at  the  Exchange  from  another  agency  about  one  of  our 
clients  may  enable  us  to  prevent  unnecessary  interference  or  may 
assure  much  needed  co-operation;  but  the  present  account  of  the 
Exchange  is  limited  to  its  uses  in  diagnosis. 

Wherever  there  has  been  no  Exchange  and  then  one  is  estab¬ 
lished,  its  possible  usefulness  is  soon  vividly  illustrated  by  such 
instances  as  the  following,  taken  from  Miss  Margaret  F.  Bying- 
ton’s  pamphlet  study  of  Exchanges:1 

In  another  city  a  Confidential  Exchange  is  just  being  started,  and  the  infant 
mortality  nurses  and  the  tuberculosis  nurses  have  not  yet  learned  to  use  it.  One 
family  was  badly  infected  with  tuberculosis,  the  father  dying,  and  the  mother  in  an 
advanced  stage  of  the  disease.  There  were  seven  children,  the  youngest  a  nursing 
baby.  The  tuberculosis  nurse  kept  urging  the  mother  to  stop  nursing  the  child, 
but  she  refused  to  do  so.  Finally  the  tuberculosis  nurse  found  that  the  infant 
mortality  nurse  had  been  visiting  the  family  and,  not  knowing  that  the  mother  had 


1  The  Confidential  Exchange,  p.  8. 
304 


SOCIAL  AGENCIES  AS  SOURCES 


tuberculosis,  was  insisting  that  she  nurse  the  child.  When  the  two  nurses  got  to¬ 
gether  on  the  case,  it  was  too  late,  for  the  baby  died  of  tubercular  meningitis. 

Here  was  failure  to  consult  owing  to  ignorance  of  the  other 
agency’s  relation,  but  our  case  reading  shows  many  instances  of 
such  failure  where  the  other  agency’s  relation  was  known.  This 
sense  of  self-sufficiency,  this  tendency  to  operate  in  a  vacuum, 
is  worn  down  by  the  successfully  administered  Exchange.  Not 
all  who  have  the  advantage  of  a  local  Exchange  use  it,  as  the  case 
just  cited  also  shows,  but  a  few  such  happenings  as  this  one  (and 
oversights  quite  as  serious  are  brought  to  light  as  soon  as  an  Ex¬ 
change  is  started)  convey  their  own  lesson. 

The  following  brief  description  of  Confidential  Exchange  ma¬ 
chinery  is  Miss  Byington’s:1 

“The  mechanism  of  the  Exchange  is  an  alphabetical  index  with 
a  card  for  each  family  or  unattached  person  known  to  any  of  the 
inquiring  agencies.  This  card  gives  the  ‘identifying  information’ 
— the  names,  ages,  and  occupations  of  the  members  of  the  family 
group,  names  and  addresses  of  relatives,  and  the  names  of  agencies 
interested,  with  the  date  on  which  each  inquired.  No  facts  about 
family  history  or  treatment  are  included.  When  a  co-operating 
society  becomes  interested  in  a  new  family,  or  in  any  one  of  its 
members,  it  inquires  at  once  whether  the  Confidential  Exchange 
knows  the  family  or  person.  This  inquiry  is  made  either  by  tele¬ 
phone  or  by  mail  on  printed  slips  furnished  by  the  Exchange. 
The  Exchange  looks  up  the  family  in  the  index,  and  then  reports 
to  the  inquiring  agency  the  names  of  any  societies  that  have  been 
previously  interested  and  the  dates  on  which  they  inquired.  If  the 
information  given  by  the  inquirer  is  not  sufficient  to  make  identi¬ 
fication  possible,  the  agency  is  so  notified,  with  the  request  that  it 
inform  the  Exchange  when  further  facts  are  secured.2  The  Chil- 

1  The  Confidential  Exchange,  p.  5  sq. 

2  The  following  on  the  subject  of  identifying  information  is  part  of  a  longer  pas¬ 

sage  in  Wigmore’s  Principles  of  Judicial  Proof,  pp.  64-65.  “The  process  of  con¬ 
structing  an  inference  of  identification  .  .  .  consists  usually  in  adding  together 

a  number  of  circumstances,  each  of  which  by  itself  might  be  a  feature  of  many  ob¬ 
jects,  but  all  of  which  together  can  conceivably  coexist  in  a  single  object  only. 
Each  additional  circumstance  reduces  the  chances  of  there  being  more  than  one  ob¬ 
ject  so  associated.  ...  It  may  be  illustrated  by  the  ordinary  case  of  identifi¬ 
cation  by  name.  Suppose  there  existed  a  parent  named  John  Smith,  whose  heirs 
are  sought;  and  there  is  also  a  claimant  whose  parent’s  name  was  John  Smith. 
The  name  John  Smith  is  associated  with  so  many  persons  that  the  chances  of  two 

20  305 


SOCIAL  DIAGNOSIS 


dren's  Aid  Society,  for  example,  inquires  about  Mrs.  Mary  Jones, 
and  is  informed  that  the  North  End  Mission  'inquired'  in  January, 

1910,  the  S.  P.  C.  C.  in  December,  1910,  and  the  Social  Service 
Department  of  the  Massachusetts  General  Hospital  in  March, 

1 9 1 1 .  The  Children's  Aid  Society  then  calls  up,  or,  better  still, 
personally  interviews,  all  these  agencies,  and  secures  directly  from 
them  what  data  they  have  about  Mrs.  Jones  and  the  story  of  their 
relations  with  her.  Experience  has  indicated  that  it  is  wiser  to 
have  no  information  in  regard  to  the  family  pass  through  the  office 
of  the  Exchange;  that  it  should  give  only  the  names  of  interested 
societies." 

It  will  be  noted  that  agencies  no  longer  "register"  but  "inquire," 
thus  placing  the  emphasis  on  the  more  important  part  of  the  proc¬ 
ess.  No  one  not  directly  and  disinterestedly  concerned,  no  one 
who  cannot  prove  that  social  betterment  is  his  aim,  should  be  en¬ 
titled  to  even  the  colorless  data  that  the  Exchange  can  supply. 
Its  facts  should  be  carefully  guarded  from  those  who  might  put 
them  to  other  uses,  such  as  installment  collectors  or  other  credi¬ 
tors.  Instead  of  invading  privacy,  the  Exchange  assures  it.  Where 
there  is  no  such  aid  to  co-operation,  or  where  agencies  whose  lines 
may  cross  refuse  to  make  systematic  inquiry  of  an  Exchange  already 
established,  it  becomes  necessary,  in  order  to  be  sure  that  effort  is 
not  being  duplicated  and  that  useful  insights  are  not  lost,  to  in¬ 
quire  directly  of  each  agency  that  might  have  known  a  given 
client.  Each  such  repetition  of  a  client's  name  to  an  agency  that 
does  not  know  him  is  rendered  unnecessary  by  the  existence  of  an 
Exchange  in  which  all  the  social  agencies  are  participants.. 

supposed  persons  of  that  name  being  different  are  too  numerous  to  allow  us  to  con¬ 
sider  the  common  mark  as  having  appreciable  probative  value.  But  these  chances 
may  be  diminished  by  adding  other  common  circumstances  going  to  form  the  com¬ 
mon  mark.  Add,  for  instance,  another  name  circumstance, — as  that  the  name  of 
each  supposed  person  was  John  Barebones  Bonaparte  Smith;  here  the  chances  of 
there  being  two  persons  of  that  name,  in  any  district,  however  large,  are  instantly 
reduced  to  a  minimum.  Or,  add  a* circumstance  of  locality, — for  example,  that 
each  of  the  supposed  persons  lived  in  a  particular  village,  or  in  a  particular  block 
of  a  certain  street,  or  in  a  particular  house;  here,  again,  the  chances  are  reduced 
in  varying  degrees  in  each  instance.  Or,  add  a  circumstance  of  family, — for  ex¬ 
ample,  that  each  of  the  persons  had  seven  sons  and  five  daughters,  or  that  each  had 
a  wife  named  Mary  Elizabeth  and  three  daughters  named  Flora,  Delia,  and  Stella; 
here  the  chances  are  again  reduced  in  varying  degrees,  in  proportion  to  the  probable 
number  of  persons  who  would  possess  this  composite  mark.  In  every  instance,  the 
process  depends  upon  the  same  principle — the  extent  to  which  the  common  mark 
is  capable  of  being  associated,  in  human  experience,  with  more  than  one  object.” 

306 


SOCIAL  AGENCIES  AS  SOURCES 


In  a  small  city  where  the  Confidential  Exchange  is  still  a  new  thing,  a  worker  in  a 
family  agency  reports  that  she  must  also  call  up  the  overseer  of  the  poor  about  each 
new  application  to  her  office,  because  he  does  not  use  the  Exchange.  She  has  found 
it  necessary  to  communicate  besides  with  a  missionary  who  is  often  working  in  an 
unrelated  way  with  the  same  families.  The  confidential  character  of  the  work  of 
the  family  agency,  the  overseer,  and  the  missionary  would  have  been  conserved  if 
all  three  had  used  the  Exchange,  for  then  no  client’s  name  need  have  been  mentioned 
to  an  agency  not  already  acquainted  with  him. 

The  reason  most  often  given  by  a  social  agency  for  refusing  to  use 
the  Exchange  is  that  its  relations  with  its  clients  are  too  confiden¬ 
tial.1  As  just  shown,  this  objection  is  based  upon  a  misappre¬ 
hension.  Nor  does  an  agreement  to  make  systematic  inquiry 
imply  obligation  to  inquire  in  every  single  instance.  There  may 
be  exceptional  cases  in  which  no  inquiry  need  be  made  or  should 
be  made,  though  these  exceptions  will  not  be  many  after  the  true 
nature  and  value  of  the  Exchange  have  been  made  apparent  by 
its  frequent  use. 

It  will  of  course  be  understood  that  the  Exchange  is  not  confined 
to  an  indexing  of  the  recipients  of  material  relief.  It  is  a  key  to 
the  knowledge  and  activities  of  those  who  have  rendered  or  are 
rendering  social  service  in  any  form,  and  its  usefulness  is  being 
rapidly  extended  far  beyond  the  boundaries  of  relief  societies  and 
other  charitable  agencies. 

Both  of  these  objections — that  their  work  is  confidential  and 
that  it  is  not  relief — have  heretofore  held  back  many  of  the  social 
settlements  from  making  inquiry.  In  so  far  as  their  work  is  with 
a  whole  neighborhood,  inquiry  of  the  Exchange  is  not  practicable, 
of  course,  but  case  work  of  any  kind — social  betterment  work, 
that  is,  with  individuals — is  helped  by  the  Exchange,  whether  it 
radiates  from  a  settlement,  a  church,  or  a  private  family  as  its 
center.  “To  the  casual  onlooker,”  says  Miss  Byington,  “the 
Confidential  Exchange,  with  its  files  of  cards,  must  seem  to  em¬ 
body  the  maximum  of  red  tape  with  the  minimum  of  ‘charity/ 
We  must  kindle  his  imagination,  that  he  may  see  as  we  do  that 
behind  the  machinery  is  a  constructive  force;  that  the  Exchange  is 
not  a  device  for  preventing  overlapping  of  relief,  that  it  is  not  a 
benevolent  detective  agency,  but  that  it  does  conserve  and  render 


1  See  The  Confidential  Exchange,  p.  13. 

307 


SOCIAL  DIAGNOSIS 


more  efficient  our  service  to  an  important  section  of  the  com¬ 
munity/'1 

III.  THE  USE  OF  EXCHANGE  DATA 

The  old  adage  about  bringing  a  horse  to  water  has  been  illus¬ 
trated  in  the  course  of  our  case  reading  by  the  very  perfunctory 
use  made  of  the  Exchange  by  some  of  the  agencies  studied.  It  is 
necessary  to  inquire  of  the  Exchange  before  acting  instead  of  after, 
if  the  clues  suggested  by  its  reports  are  to  be  of  any  real  service. 
And  there  is  no  particular  merit  in  consulting  the  Exchange,  even 
with  great  promptness,  if  the  clues  which  it  furnishes  are  not  in¬ 
telligently  followed  up. 

It  is  true  that,  in  a  city  in  which  the  Exchange  is  well  established 
and  widely  used,  the  clues  furnished  are  sometimes  bewilderingly 
many;  some  of  them  may  yield  little  of  value;  and  always  the  time 
element  makes  necessary  an  intelligent  choice  of  the  order  in  which 
social  agency  clues  shall  be  consulted. 

In  the  case  of  Boston,  where  so  many  agencies  inquire  of  the 
Exchange  that  this  is  particularly  true,  the  writer  has  had  the  op¬ 
portunity  to  examine  a  group  of  reports  on  the  practice  of  a  large 
number  of  agencies  using  the  Exchange.2  Some  send  letters  at 
once  to  all  clues  furnished  by  the  Confidential  Exchange,  some 
select  for  a  first  consultation  the  agency  most  like  their  own,  some 
consult  first  the  one  that  is  most  conveniently  situated  for  a  prompt 
personal  interview,  some  go  first  to  those  in  whose  methods  they 
have  the  most  confidence,  many  consult  at  once  the  agency  that 
inquired  last  of  the  Exchange,  and  many  others  consult  first  the 
Associated  Charities,  when  its  name  appears  in  the  list  of  clues, 
consulting  next  the  agency  most  like  their  own.  These  reports 
cannot  be  taken  as  proof  of  the  wisdom  or  unwisdom  of  any 
definite  principles  of  choice — they  were  gathered  too  informally — 
but  they  are  suggestive.  The  agencies  that  always  consulted  the 
Boston  Associated  Charities  first  usually  gave  as  their  reason  that 

1  Miss  Byington  makes  it  clear  that  something  more  than  good  clerks  and  a  sound 
office  system  is  needed  in  a  successful  Exchange.  It  must  be  administered  by  social 
workers  who  are  fully  alive  to  its  progressive  case  work  possibilities.  It  must  be 
assured  continuity  of  policy,  and  that  policy  social  in  the  highest  sense. — The  Con¬ 
fidential  Exchange,  p.  22. 

2  Contained  in  notes  of  two  informal  conferences  held  in  April,  1915,  by  students 
of  the  Boston  School  for  Social  Workers,  for  which  the  writer  is  indebted  to  Miss 
Zilpha  D.  Smith. 


308 


SOCIAL  AGENCIES  AS  SOURCES 


this  particular  agency  studied  the  general  family  history  very  care¬ 
fully,  and  always  covered  the  clues  furnished  by  the  Exchange, 
thus  rendering  first-hand  consultations  with  each  and  every  one 
of  these  clues  unnecessary.  The  agencies  that  invariably  consulted 
first  the  Exchange  inquirer  of  latest  date  usually  gave  as  their 
reason  that  this  source  was  most  likely  to  know  about  the  present 
situation. 

Here  we  have  somewhat  divergent  tendencies,  which  recall  the 
principle  of  choice  suggested  in  Chapter  VIII,  Outside  Sources 
in  General,  that  sources  rich  in  history  only  be  sought  before  those 
likely  to  prove  rich  in  co-operation.  It  is  to  be  expected  that  some 
agencies  will  be  most  occupied  with  the  present  situation,  and  that 
others,  seeking  a  broader  basis  for  what  may  prove  a  longer  treat¬ 
ment  and  one  looking  to  more  permanent  results,  are  eager  to  get 
a  good  family  background  for  their  diagnosis  and  prognosis.  A 
placing-out  agency  is  unquestionably  more  likely  to  get  the  special 
information  that  it  needs  from  another  placing-out  agency,  and, 
more  important  still,  it  is  more  likely  to  find  that  some  one  capable 
of  taking  full  charge  has  already  accepted  the  responsibility  or 
wishes  to  do  so.  There  is  much  to  be  said  for  propinquity  also. 
For  instance,  an  agency  in  a  charities  building  on  the  next  floor 
but  one  can  be  seen  at  once,  and  the  direct  communication,  with 
its  fair  chance  of  seeing  the  particular  worker  in  the  agency  who 
knows  the  client  best  and  its  further  chance  of  hearing  him  detail, 
with  case  record  in  hand,  the  agency’s  information  and  experience, 
has  very  definite  advantages.1  In  theory,  the  agency  that  last 
inquired  has  either  left  the  case  in  charge  of  another  willing  to 
assume  full  responsibility  or  else  has  inquired  of  all  the  previous 
inquirers,  and  is  in  a  position  to  pass  on  their  data;  but  with  each 
remove  such  information  tends  to  become  diluted,  so  that  the  most 
that  can  be  hoped  for  from  the  best  of  social  agency  witnesses  is  a 
hint  as  to  what  kind  of  information  we  are  likely  to  find  from  the 
other  agencies  reported  by  the  Exchange.  If  we  consult  only  those 
whose  methods  of  investigation  we  approve,  a  process  of  in-breed¬ 
ing  and  of  separation  begins  at  once,  which  may  have  serious  effects 
upon  our  own  work  and  upon  community  co-operation  later. 

1  For  a  discussion  of  the  telephone  as  a  medium  of  communication  in  the  proc¬ 
esses  leading  to  diagnosis  see  the  next  chapter. 

309 


SOCIAL  DIAGNOSIS 


In  summing  up  these  conferences,  Miss  Zilpha  D.  Smith  gives, 
as  the  first  purpose  of  calling  up  previous  inquirers,  “To  find  out 
if  any  other  organization  holds  itself  responsible  for  the  social 
treatment  of  the  family  or  person,  or  responsible  for  making  a 
plan.  If  so,  to  report  how  their  affairs  came  to  our  notice  and  why. 
Also,  to  help,  if  need  be,  the  family  or  person  to  co-operate  with 
the  other  organization.”  When  no  such  responsibility  has  been 
assumed  and  treatment  therefore  becomes  necessary,  the  second 
purpose  is  to  profit  by  the  experiences 'of  the  agencies  reported  as 
having  inquired,  and  to  utilize  any  items  of  history  that  they  may 
have  gathered. 

After  treatment  of  a  case  has  ceased,  the  notifications  that  con¬ 
tinue  to  come  in  from  the  Exchange  that  the  former  client  has  been 
inquired  about  by  successive  agencies  are  often  thrust  aside  or 
destroyed.  Even  if  no  attention  is  paid  to  these  notices  at  the 
time,  and  sometimes  they  require  attention,  they  should  be  saved 
for  future  reference,  for  treatment  may  have  to  be  resumed  at  a 
later  date. 

It  is  well  to  remind  ourselves,  in  leaving  this  subject  of  the  use  of 
Exchange  data,  that  no  system  of  indices  can  take  the  place  of  a 
quick  and  resourceful  summoning  of  concrete  case  experiences 
into  consciousness.  Some  social  agencies  would  have  been  satis¬ 
fied  to  return  a  prompt  negative  to  the  following  inquiry: 

A  woman  calling  herself  Sarah  Collier  Potter,  who  claimed  that  she  was  recently 
widowed  and  penniless,  applied  to  a  child-protective  agency.  She  had  with  her  a 
two-year-old  boy  named  George  and  was  soon  to  become  a  mother.  As  the  in- 
town  addresses  she  gave  were  false,  the  agency  wrote  to  the  overseer  of  the  poor  in 
a  nearby  town  on  the  chance  that  Mrs.  Potter  might  be  known  to  him,  at  the  same 
time  adding  some  descriptive  details.  The  overseer  replied  that  he  knew  of  no 
Sarah  Collier  Potter,  but  that  some  items  in  the  story  suggested  that  she  might  be 
Bridget  Karrigan,  who  had  sometimes  given  the  name  of  Collier,  and  who  was  an 
unmarried  woman  now  pregnant  and  mother  of  a  boy  of  two  named  George.  Then 
followed  a  clear  account  of  Bridget’s  occupations,  application  to  court  for  support 
of  her  child,  etc.  These  cases  were  found  to  be  identical.  An  index  alone  could 
hardly  have  established  the  fact. 

IV.  SOME  FURTHER  DETAILS  OF  CO-OPERATION 

Almost  every  aspect  of  the  ethics  and  technique  of  consultation 
is  involved  in  the  right  use  of  the  confidential  exchange.  There 
are,  however,  certain  details  of  co-operative  relations  that  require 

310 


SOCIAL  AGENCIES  AS  SOURCES 


separate  treatment,  such  as  the  knotty  problem  of  duplicate  in¬ 
vestigations,  the  advisability  of  investigation  that  probably  will 
be  followed  immediately  by  transfer  to  another  agency,  and  certain 
daily  helps  in  the  practical  working  out  of  co-operation  as  it  relates 
to  diagnosis. 

1.  Duplicate  Investigations.  In  the  earliest  stages  of  this  in¬ 
quiry  into  social  diagnosis,  a  meeting  of  representatives  from  31 
local  social  agencies  was  held  in  one  of  our  large  cities.  Again 
and  again,  in  the  course  oi  the  frankly  informal  discussion  of  co¬ 
operative  relations  with  which  the  evening  was  filled,  the  topic  of 
duplicate  investigations  was  returned  to.  Some  present  felt  that 
overlapping  of  investigation  was  quite  as  great  an  evil  as  the  over¬ 
lapping  of  relief — an  evil  not  traceable  to  any  failure  to  use  the 
local  confidential  exchange,  for  all  present  inquired  of  it  system¬ 
atically,  but  due,  rather,  to  unwillingness  to  accept  the  investiga¬ 
tions  and  recommendations  of  others  as  a  satisfactory  basis  for 
action  without  supplementary  inquiry. 

Inquiries  that  cover  the  same  ground  needlessly  and  repeatedly 
are  undoubtedly  not  only  a  hardship  to  our  clients  but  an  injury  to 
them,  for  under  the  experience  they  can  become  as  abnormally 
self-conscious  and  self-pitying  as  are  certain  of  the  more  well-to-do 
who  flit  from  doctor  to  doctor. 

At  the  same  time,  no  general  arrangement  to  pool  our  social 
diagnoses  will  furnish  a  way  out  of  the  dilemma,  so  long  as  stan¬ 
dards  of  investigation  are  so  capriciously  variable.  One  reason 
why  agencies  cannot  agree  at  present  to  accept  the  investigations 
of  others  wholesale  is  that  they  cannot  trust  them  to  be  good, 
though  they  should  be  perfectly  willing  to  take  the  facts  of  another 
agency  in  so  far  as  they  can  be  assured  that  they  really  are  facts. 
The  slow  development  of  a  sound  technique  in  common  is  the  only 
sure  way  of  overcoming  the  worst  results  of  over-inquiry.  Dupli¬ 
cation  will  seem  inexcusable  in  a  community  in  which  such  a  tech¬ 
nique  has  been  mastered  by  all  case  workers.  If,  however,  by 
duplicate  investigation  is  meant  any  inquiry  by  more  than  one 
agency,  there  is  little  doubt  that,  for  the  best  interests  of  our 
clients,  such  duplication  must  continue.  The  idea  of  one  broadly 
comprehensive  inquiry,  covering  all  the  social  aspects  of  a  family's 
life,  made  once  only  and  then  placed  forever  after  at  the  service 

3ii 


SOCIAL  DIAGNOSIS 


of  all  social  workers  interested  in  any  of  the  family’s  members  as  a 
substitute  for  further  investigation,  is  a  doctrinaire  conception 
originating  probably  with  the  charity  organization  societies  but 
now  for  the  most  part  outgrown  by  them.  As  a  basis  for  social 
inquiry  the  family  point  of  view  is  valuable  beyond  question,  and 
certain  data  so  gathered  will  not  need  to  be  regathered,  but  there 
will  have  to  be  reinquiry  as  circumstances  change,  as  new  ques¬ 
tions  arise,  and  as  a  new  form  of  social  service,  requiring  its  separate 
skill  and  separate  data,  is  needed.  The  new  agency  called  in 
should  utilize  the  older  experience,  of  course,  but  it  will  not  only 
have  to  bring  this  experience  up  to  date,  but  must  seek  besides 
the  particular  insight  into  the  situation  and  the  personality  which 
is  necessary  for  the  new  task  in  hand.  The  oculist  already  re¬ 
ferred  to  (p.  303)  did  not  rest  back  upon  the  very  satisfactory  data 
furnished,  but  made  his  re-examination  with  those  data  in  mind. 

Practical  illustrations  of  most  of  these  difficulties  were  pre¬ 
sented  at  the  meeting  at  which  the  elimination  of  inquiry  by  more 
than  one  agency  was  urged.  A  medical-social  worker — to  take  an 
extreme  instance — stated  that,  in  certain  cases,  the  most  important 
single  item  of  her  inquiry  was  to  discover  what  a  patient  had  had 
for  breakfast  that  morning — a  matter  which  obviously  could  not 
be  referred  back  to  someone  who  was  supposed  to  have  a  more 
comprehensive  knowledge  of  the  patient.  The  after-care  agent 
of  a  girls’  reformatory,  whose  cordial  relations  with  the  local 
society  to  protect  children  were  based  upon  many  case  work  views 
held  in  common,  pointed  out  that  written  reports  from  the  society 
inevitably  emphasized  those  aspects  of  a  girl’s  history  for  which 
the  community  held  that  particular  society  responsible,  whereas  a 
visit  to  the  agent  of  the  society  who  had  known  the  girl  usually 
brought  out  useful  information  that,  for  the  original  investigator’s 
purposes,  had  not  seemed  even  worth  recording.  In  addition  to 
these  items,  however,  new  questions  had  usually  come  up  that 
made  reinvestigation  necessary — a  new  decision  had  to  be  made, 
and  its  very  nature  suggested  lines  of  inquiry  not  already  covered, 
such  as  further  detailed  characteristics  of  a  certain  relative  now 
willing  to  take  the  girl,  the  more  recent  physical  and  mental  his¬ 
tory  of  the  girl  herself,  etc. 

Neither  confidential  exchanges  nor  uniform  record  cards,  n©r 

312 


SOCIAL  AGENCIES  AS  SOURCES 


the  businesslike  agreements  sometimes  suggested  by  efficiency  ex¬ 
perts  who  know  little  or  nothing  about  social  case  work,  will  suc¬ 
ceed  in  eliminating  supplementary  investigation,  but,  with  such 
efficient  aids  as  a  thorough  standard  of  diagnosis,  re-enforced  by 
thorough  use  of  the  confidential  exchange,  the  duplicate  investi¬ 
gation  which  really  duplicates  and  to  which,  therefore,  there  can  be 
reasonable  objection,  will  gradually  disappear. 

2.  The  Transfer  to  Another  Agency  for  Treatment.  When  the 
first  steps  in  our  relations  with  a  new  client  indicate  that  he  is 
probably  in  more  need  of  the  services  of  another  agency  than  of 
our  own,  how  far  should  we  go  with  our  inquiry  preliminary  to 
diagnosis  before  referring  him,  and  what  should  our  further  rela¬ 
tions  be  to  him  and  to  the  agency  after  the  transfer  has  been 
effected?  Evidence  on  the  first  of  these  two  questions  is  very 
conflicting.  Some  of  it  seems  to  indicate  that  the  first  agency 
should  go  far  enough  at  least  to  be  quite  sure  that  the  transfer  is  a 
justifiable  one.  Emphasis  on  this  side  could  be  defended,  in  part, 
by  the  fact  that  under  pressure  of  work  most  case  workers  tend  to 
accept  quite  readily  any  indication  that  a  particular  demand  upon 
their  time  and  sympathy  can,  with  decency,  be  set  aside  or  passed 
on  to  others.  The  unfortunate  results  of  this  tendency  are  ag¬ 
gravated,  sometimes,  by  another  transfer,  made  for  much  the 
same  reason  by  the  second  agency,  to  a  third.  A  further  argu¬ 
ment  against  the  ill  considered  reference  is  that  it  is  one  of  the 
greatest  bars  to  co-operation.  Obviously,  we  cannot  co-operate 
with  an  agency  the  purposes  and  limitations  of  which  we  have 
never  concerned  ourselves  to  discover;  but  however  well  we  may 
know  these  purposes  and  limitations,  unless  we  know  also  some¬ 
thing  more  than  can  be  learned  at  an  application  desk  of  the 
clients  whom  we  refer  to  the  agency,  we  shall  continually  be  asking 
it  to  do  things  not  at  all  within  its  scope. 

On  the  other  hand,  the  social  organization  which  tries  to  do 
thorough  work  likes  cases  referred  to  it  promptly.  One  of  the 
most  cheering  developments  in  connection  with  tasks  formerly 
undertaken  only  at  the  eleventh  hour  is  that  they  are  now  develop¬ 
ing  a  preventive  side;  but  preventive  measures  seldom  succeed 
without  the  early  reference.  This  is  notably  true  of  various  forms 
of  what  was  formerly  court  work  or  nothing.  The  case  records  of 

313 


SOCIAL  DIAGNOSIS 


one  society  for  the  protection  of  children  show  a  good  deal  of  work 
in  co-operation  with  other  agencies  and  with  parents  themselves, 
in  which,  by  timely  treatment,  court  intervention  was  rendered 
unnecessary.  Dr.  William  Healy,  working  exclusively  at  first 
with  the  Chicago  Juvenile  Court,  was  later  often  appealed  to  by 
parents,  clergymen,  and  teachers  for  an  expert  opinion  on  a  difficult 
child  that  had  no  court  record.1  We  cannot  always  be  sure,  of 
course,  that  our  first  reference  will  be  the  right  one,  and  any  ten¬ 
dency  to  delay  too  long  in  seeking  co-operation  may  make  effective 
treatment  more  difficult. 

Another  possible  argument  against  investigation  before  transfer 
is  that  a  client  who  must  be  transferred  goes  more  readily  and 
gives  a  second  agency  his  confidence  more  freely  if  he  has  not  been 
visited,  interviewed,  questioned  by  the  first  agency  just  before 
the  transfer  was  made.  The  more  complete  the  understanding 
between  the  two  agencies,  the  less  will  be  the  difficulty  from  this 
last  obstacle. 

As  with  so  many  other  questions  raised  in  this  book,  there  can 
be  no  one  conclusive  answer.  The  matter  of  investigation  before 
transfer  cannot  be  settled  by  a  formula.  We  can  be  on  guard, 
however,  against  the  very  natural  tendency  to  relieve  ourselves  of 
trouble  by  hasty  transfers,  and  we  can  be  sure  that  no  endeavor 
put  into  strengthening  the  relations  of  our  client  to  the  agency  to 
which  he  is  being  transferred  will  be  wasted. 

Says  a  critic  of  a  group  of  case  records:  The  entry  “disposed  of  through  the 

juvenile  court,”  or  “removed  to - ”  (another  city  or  town  or  some  place  in  the 

country),  is  a  form  of  social  bookkeeping  entry  that  may  indicate  no  real  conclu¬ 
sion  of  the  social  difficulty.  All  environmental  changes  need  analysis,  if  we  are 
to  be  thorough. 

There  can  be  no  two  opinions,  of  course,  about  the  folly  of  tak¬ 
ing  up  the  case  of  a  transferred  client  anew,  later  on,  without  con¬ 
sulting  with  the  organization  to  which  we  transferred  him. 

A  single  woman  in  need  of  light  work,  for  example,  was  referred  to  a  family  agency 
by  a  medical-social  department.  The  family  agency  provided  convalescent  care 
and  later  found  work  for  her.  About  a  year  and  a,  half  later  she  applied  to  the 
hospital  again  for  medical  care  and  was  visited  by  its  social  service  department. 
Following  this  second  application,  an  auxiliary  of  the  department  provided  sewing 

xThe  Individual  Delinquent,  p.  14. 

314 


SOCIAL  AGENCIES  AS  SOURCES 


for  six  months  and  rendered  other  service  without  making  any  inquiry  of,  or  at¬ 
tempting  to  confer  with,  the  family  agency  previously  called  in. 

3.  Additional  Suggestions.  Communication  with  other  social 
organizations  should  be  direct  and  not  through  clients  or  any  other 
intermediaries.  Statements  and  messages  are  often  repeated  in¬ 
accurately  in  all  innocence,  and  sometimes  they  are  colored  by  the 
interest  of  the  messenger. 

A  conference  of  representatives  of  several  agencies — of  all 
interested  in  some  one  case  which  happens  to  present  special  dif¬ 
ficulties — may  save  valuable  time,  promote  good  understanding, 
and  bring  the  solution  appreciably  nearer.  A  certain  agency  has 
refused,  perhaps,  to  accept  the  point  of  view  of  another.  It  is  not 
impressed  with  the  reasons  given  and  believes  the  diagnosis  or  the 
prognosis  or  both  to  be  mistaken.  At  the  conference  of  all  inter¬ 
ested,  however,  it  is  impressed,  or  else  the  organization  from  which 
it  has  differed  is  impressed,  by  the  point  of  view  of  a  third,  or  by 
the  new  light  thrown  upon  the  matter  by  a  doctor  or  teacher  who 
is  present.  The  outcome  is  not  necessarily  the  one  intended  by 
the  agency  calling  the  conference;  a  better  policy  may  be  adopted 
than  that  originally  favored  by  either  of  the  two  disputants. 

Since  co-operation  is  based  upon  trust,  one  final  suggestion  under 
this  head  may  well  emphasize  the  importance  of  teaching  co-operat¬ 
ing  agencies  that  we  are  as  good  as  our  word  always.  If  we  have 
said  that  we  will  do  a  thing,  it  should  be  known  to  be  as  good  as 
done. 


SUMMARY  OF  THIS  CHAPTER 

1.  The  process  of  arriving  at  a  social  diagnosis  is  a  co-operative  one.  Properly 
conducted,  moreover,  it  often  leads  to  the  intelligent  co-operation  of  relatives,  em¬ 
ployers,  social  agencies,  etc.,  in  the  treatment  which  is  to  follow  diagnosis. 

2.  As  regards  social  agencies,  the  four  stages  of  development  from  competition 
to  co-operation  in  their  social  work  are  (i)  the  competitive  period,  (2)  the  period  of 
co-operation  in  vacuo,  (3)  the  period  of  “joint  traffic  agreements,”  (4)  the  period  of 
co-operation  in  spirit. 

3.  As  outside  sources,  social  agencies  belong  upon  a  different  plane  from  all 
others,  and  to  their  evidence  somewhat  different  tests  must  be  applied.  They  ful¬ 
fill  two  distinct  functions  as  witnesses:  first,  they  can  supply  their  own  social  ex¬ 
perience  with  a  given  client;  second,  they  can  often  supply  certain  objective  data 
about  him.  Some  agencies  excel  in  the  one  kind  of  testimony,  some  in  the  other, 
and  a  small  group  in  both. 


3J5 


SOCIAL  DIAGNOSIS 


4.  In  evaluating  its  testimony,  the  point  of  view  of  the  individual  agency  must  be 
considered  and  allowed  for.  Other  things  being  equal,  that  type  of  social  experience 
which  is  least  like  our  own  is  most  valuable — the  agency  developed  on  the  neighbor¬ 
hood  unit  helps  most  the  one  that  regards  the  family  as  its  unit  of  measure,  etc. 
If  there  has  been  a  complete  change  of  management  in  an  agency,  it  is  important 
to  know,  in  each  instance,  whether  its  case  report  refers  to  work  done  before  or 
after  the  change. 

5.  A  systematic  and  confidential  exchange  of  identifying  information  among 
social  agencies  assures  better  diagnosis  and  treatment,  promotes  better  understand¬ 
ing  between  agencies,  reduces  duplication  of  effort,  and  increases  the  sense  of  in¬ 
dividual  responsibility  for  work  undertaken. 

6.  Prompt  consultation  of  the  exchange  is  essential,  however,  and  a  prompt  fol¬ 
lowing  up  of  the  clues  which  it  supplies. 

7.  The  order  in  which  the  social  agency  clues  so  followed  up  should  be  consulted 
depends  upon  a  number  of  factors;  but,  in  general,  the  first  thing  to  seek  is  assurance 
that  the  entrance  of  our  own  agency  into  a  given  case  would  not  duplicate  effort 
or  interfere  with  the  treatment  of  some  other  agency;  second,  when  this  first  point 
has  been  settled,  history  useful  in  our  own  diagnosis;  third,  co-operation  in  treat-' 
ment. 

8.  Additional  investigation  is  not  necessarily  a  duplication  of  effort,  but  over¬ 
inquiry  will  best  be  done  away  with  by  a  high  and  widely  accepted  standard  of 
diagnosis. 

9.  Communication  between  social  practitioners  should  be  direcLan4  not  through 
their  clients  or  other  intermediaries. 


316 


CHAPTER  XVII 


LETTERS,  TELEPHONE  MESSAGES,  ETC. 

UR  review  of  outside  sources  is  ended,  but  before  leaving 


this  part  of  our  subject  for  an  analysis  of  the  last  stage  of 


all  in  the  processes  leading  to  diagnosis,  there  are  certain 
things  to  be  said  about  the  various  means  of  communication  with 
outside  sources  and  the  relative  uses  to  which  these  means  may  be 
put.  Of  the  statements  procured  by  different  means,  which  ones 
(other  things  being  equal)  are  most  satisfactory — those  that  are 
(a)  written  replies  to  the  questions  on  a  form  or  schedule,  (b)  writ¬ 
ten  replies  to  letters,  (c)  telephone  replies  to  questions  asked  by 
telephone,  (d)  telegraphic  replies  to  inquiries  made  through  the 
same  medium  or  (e)  replies  by  word  of  mouth  secured  in  the  course 
of  a  personal  interview?  Many  other  combinations  of  these  means 
are  possible,  of  course,  but  taking  these  five  main  forms  of  com¬ 
munication  without  their  variations,  from  which  one,  on  the  whole, 
does  the  social  case  worker  win  the  best  results?  The  personal 
interview  has  become  his  main  reliance.  There  are  exceptions  to 
this,  but  to  an  increasing  degree  it  is  true  in  most  forms  of  case 
work. 

Oral  testimony  fails  us  when  accuracy  is  vital,  as  in  matters  of 
time,  place,  amount,  etc.,  but  so  does  written  testimony,  unless 
we  seek  the  original  documents.1  The  distinguishing  character¬ 
istic  of  social  evidence  is  not,  however,  its  handling  of  objective 
matters,  but  its  ability  to  evaluate  human  relations.  It  is  justified 
as  a  separate  type  of  evidence  by  its  possible  usefulness  in  gauging 
the  interest,  capacity,  and  whole  atmosphere  and  spirit  of  the 
individual  witness,  including  his  capacity  to  become  more  inter¬ 
ested  than  he  now  is.  In  subjective  matters  such  as  these  there  is 
no  satisfactory  substitute  for  the  personal  interview. 

A  policeman  wrote  from  a  small  town  to  an  associated  charities  secretary  about 
a  family  in  which  the  husband  was  very  abusive.  After  giving  certain  information. 


1  See  Chapter  XIII,  Documentary  Sources. 

3‘7 


SOCIAL  DIAGNOSIS 


he  added,  “  If  I  could  see  you,  I  could  say  many  things  which  I  think  it  would  be  just 
as  well  not  to  write,  for  the  reason  that  the  explanation  would  take  a  lot  of  time  and 
paper  and  then  perhaps  would  not  be  very  satisfactory — you  know  how  it  is.” 


A  woman  probation  officer  was  asked  to  inquire  into  the  story  of  a  young  girl 
arrested  for  immoral  conduct  who  gave  the  name  of  Emily  Burton.  The  girl  said 
that  she  came  from  the  town  of  G - ,  about  sixty  miles  away,  and  that  her  people 


were  French  Canadians  and  Catholics.  Her  name  seemed  unmistakably  Anglo- 
Saxon,  but  she  persisted  that  she  had  no  other,  so  the  probation  officer  decided  to 

go  herself  to  G - ,  and  follow  personally  the  very  slender  clues  that  were  in  her 

hand.  First,  she  saw  the  police  captain  there,  and  interested  him  to  assign  an  officer 
to  accompany  her  on  her  search,  but  the  girl’s  parents  could  not  be  found  at  the 
address  given  or  anywhere  in  that  street  or  neighborhood.  School  records  revealed 
nothing,  nor  could  the  parish  priest  identify  the  family  from  the  description.  The 
mill  in  which  the  girl  claimed  to  have  worked  was  the  next  to  the  last  clue,  but  it 
yielded  nothing.  Returning  to  the  captain  of  police,  the  probation  officer  told  him 
of  a  brother  George  who  worked  for  a  farmer  (or  so  the  girl  claimed),  but  the  only 
George  known  at  police  headquarters  who  worked  for  a  farmer  was  named  Lodie, 
and  the  probation  officer  did  not  even  attempt  to  see  him. 

On  the  day  of  the  trial,  and  just  before  it  began,  the  girl  begged  hard  for  mercy, 
but  the  probation  officer  was  forced  to  point  out  in  all  kindness  that  she  did  not 
even  know  who  she  was.  Whereupon  the  girl  said  that  her  name  was  Lodie  and  that 
she  really  did  live  in  G - .  The  identification  of  this  one  name  more  than  justi¬ 


fied  what  had  seemed  a  futile  journey,  for  it  gave  promise  that  there  was  further 
truth  in  the  girl’s  story.  A  second  visit  to  G - brought  to  light  five  respectable 


brothers  and  sisters,  with  four  of  whom  the  officer  was  able  to  consult.  This  led  to 
plans  of  co-operation  with  the  girl’s  mother,  to  the  return  home  of  the  wanderer, 
who  had  been  denied  a  welcome  earlier,  and  to  plans  for  her  continuous  supervision 
under  suspended  sentence. 


Where  such  serious  issues  are  involved  as  in  the  case  just  cited, 
it  is  no  unusual  thing,  now,  for  case  workers  to  travel  from  one  end 
of  a  state  to  another  or  into  other  states  to  make  an  inquiry  in 
person.  At  one  time  this  would  have  been  regarded  as  a  very 
wasteful  procedure,  but  much  footless  endeavor — expensive  in 
time  and  money,  and  expensive  in  its  results — has  been  saved  by 
such  journeys. 

I.  B.LANK  FORMS 

Many  charitable  institutions  still  select  their  inmates  on  the 
basis  of  statements  filled  out  on  application  blanks,  to  which  are 
appended  certain  letters  of  endorsement.  The  formality  of  these 
blanks  is  believed  to  secure  greater  accuracy  in  the  replies.  Where 
inaccurate  replies  are  a  statutory  offense,  punishable  by  fine  or 
imprisonment,  there  may  be  justification  for  this  view,  but  such 

318 


LETTERS,  TELEPHONE  MESSAGES,  ETC. 

powers  seldom  reside  in  social  agencies,  either  public  or  private,  and 
where  they  do  they  are  not  always  used.  The  logically  arranged 
and  categorically  framed  questions  of  an  application  blank  suggest 
the  answer  that  will  lead  to  the  decision  desired  by  the  applicant. 
This  is  the  chief  objection;  another  is  that  no  formal  set  of  ques¬ 
tions,  however  full,  can  cover  all  possible  contingencies;  a  blank 
may  be  carefully  and  accurately  filled  out  by  a  witness  and  yet 
omit  important  items.  As  regards  the  letters  of  endorsement 
which  usually  accompany  such  applications,1  written  by  merchants, 
teachers,  clergymen,  doctors,  and  other  presumably  responsible 
persons,  these  are  too  often  found  to  be  not  worth  the  paper  upon 
which  they  are  written,  as  some  of  the  cases  cited  in  this  volume 
show.2 

II.  LETTERS  OF  INQUIRY 

The  author’s  examination  of  case  records  indicates  greater 
advances  during  the  last  decade  in  the  art  of  conducting  personal 
interviews  than  in  the  art  of  letter  writing.  This  is  natural,  per¬ 
haps,  for  the  attempt  to  make  social  diagnosis  a  more  flexible  and 
understanding  thing  has  been  pushed  forward  under  many  dis¬ 
advantages,  of  which  time  pressure,  public  impatience,  and  in¬ 
adequate  preparation  are  only  a  few.  Under  these  handicaps  the 
substitution  of  visits  for  letters  has  diverted  attention  from  the 
possibilities  of  letters  in  those  cases,  still  numerous,  in  which  they 
should  be  used.  As  a  result,  many  of  the  carbon  copies  of  letters 
found  in  case  records  have  the  air  of  having  been  written  or  dic¬ 
tated  in  a  most  perfunctory  and  absent-minded  way. 

A  case  worker’s  letters,  in  so  far  as  they  relate  to  diagnosis,  fall 
into  the  two  large  groups  of  those  that  ask  information  about  clients 
and  those  that  give  information.  Those  that  ask  information  may 
be  divided  into  letters  that  ask  it  of  the  witnesses  direct  and  letters 
that  ask  it  of  intermediaries  who  are  requested  to  see  the  witnesses 
or  to  communicate  with  them  in  some  other  way.  Again,  letters 
that  ask  information  direct  may  be  divided  into  those  that  ask 
it  of  persons  near  enough  at  hand  to  make  a  personal  interview 
with  them  later  quite  easy  or  at  least  possible,  and  those  in  which 

1  Some  institutions  and  agencies  provide  a  form  of  recommendation  requiring 
nothing  but  the  signature  of  the  endorser. 

2  See,  for  example,  pp.  232  and  241. 

319 


SOCIAL  DIAGNOSIS 


the  opportunity  for  such  direct  communication  later  is  remote  or 
non-existent.  Obviously,  each  one  of  these  divisions  and  subdi¬ 
visions  demands  from  the  letter  writer  a  somewhat  different  method 
of  presentation,  though  attention  will  be  given  here  almost  exclu¬ 
sively  to  letters  of  out-of-town  inquiry  and  their  replies. 

In  respect  of  letters  of  inquiry  (to  take  this  half  of  the  subject 
first)  the  question  that  precedes  every  other  is  (i)  What  other 
means  of  communication,  at  command,  would  serve  the  purpose 
better?  This  settled  in  favor  of  the  letter,  as  the  best  available 
means,  the  next  question  is  (2)  Have  the  preliminary  inquiries  that 
would  make  the  writing  of  this  letter  the  logical  next  step  all  been 
made?  And  (3)  Has  the  definite  relation  of  the  part  of  the  inquiry 
to  be  covered  by  the  letter  to  the  whole  of  diagnosis  and  treatment 
been  thought  out  by  the  inquirer  as  clearly  as  it  can  be  at  this 
early  stage?  Only  when  this  has  been  done  can  be  found  the  an¬ 
swer  to  the  next  question,  which  is  (4)  Has  the  best  possible  corre¬ 
spondent  been  chosen  for  the  particular  information  or  the  particu¬ 
lar  service  desired?  (5)  If  so,  what  method  of  presentation  will 
most  interest  him,  and  so  win  the  information  or  the  service?  (6) 
How,  for  instance,  can  the  trouble  to  which  he  will  be  put  by  the 
inquiry  be  justly  measured,  and  every  effort  be  made  to  anticipate 
his  difficulties  and  give  him  the  details  that  will  help  him  to  over¬ 
come  them?  (7)  If  the  correspondent  is  not  personally  known,  as 
often  happens,  what  circumstances  of  his  occupation,  experience, 
education,  and  of  his  relation  to  this  particular  problem  should  be 
borne  in  mind  and  turned  to  account  in  the  attempt  to  make  the 
significance  and  possibilities  of  the  inquiry  clear  to  him?  Each  of 
these  questions  deserves  amplification. 

1.  Should  the  Letter  Be  Written  at  All?  The  advantages  of  a 
personal  interview  have  been  made  clear.  When  letters  are  the 
sole  means  of  communication  with  persons  who  do  not  understand 
the  case  worker's  point  of  view  or  whose  attitude  and  character¬ 
istics  are  unknown  to  him,  his  work  is  seriously  handicapped  from 
the  beginning.  Some  letters  are  merely  preliminary  to  an  inter¬ 
view;  others  follow  it,  to  secure  in  black  and  white  data  of  a 
technical  or  of  a  purely  objective  nature,1  in  which  accuracy  is 

1  Many  hospitals  refuse  to  give  a  diagnosis  unless  written  application  is  made  for 
it. 


320 


LETTERS,  TELEPHONE  MESSAGES,  ETC. 

of  the  first  importance.  These  present  no  difficulties,  but  less  di¬ 
rect  means — letters,  long  distance  telephone  messages,  telegraphic 
dispatches — must  often  be  the  only  approach.  In  more  than  n 
per  cent  of  all  the  outside  sources  consulted  in  the  2,800  cases 
included  in  our  special  study,  the  agencies  and  persons  communi¬ 
cated  with  were  out  of  town.  Letters  to  out-of-town  sources  tax 
the  case  worker's  ingenuity  far  more  than  does  his  other  corre¬ 
spondence,  and  except  when  otherwise  specified  this  discussion 
is  limited  to  them. 

2.  Should  the  Letter  Be  Written  Now?  A  favorite  time  for 
writing  letters  of  inquiry  is  just  after  the  first  interview  has  been 
held.  When  no  one  living  in  or  near  the  city  in  which  the  client 
makes  his  application  has  had  any  but  the  most  casual  contacts 
with  him,  letters  to  those  at  a  distance  who  have  known  him  well, 
or  to  others  who  will  visit  these  witnesses,  are  a  necessary  procedure 
and  such  letters  must  be  written  at  once.  A  safe  general  rule  to 
follow,  nevertheless,  is  this:  Write  no  important  letter  to  a  place 
at  a  distance  which  is  not  based  upon  and  shaped  by  all  the  ob¬ 
tainable  evidence  near  at  hand.  Much  of  the  growing  dissatisfac¬ 
tion  among  agencies  which  receive  many  out-of-town  requests  for 
inquiry  service — notably  among  the  charity  organization  societies 
upon  which  this  demand  has  fallen  the  heaviest — may  be  traced  to 
the  fact  that  many  requests  are  made  upon  very  inadequate  data 
when  it  is  known  that  more  data  near  at  hand  are  readily  obtain¬ 
able.  On  the  other  hand,  it  must  be  conceded  that  there  is  real 
danger  in  delaying  out-of-town  inquiry  until  after  plans  have  been 
made  and  the  case  treatment  has  actively  been  started. 

A  flagrant  instance  of  the  inquiry  that  should  have  been  made, 
and  yet  was  made  too  soon,  will  be  found  on  page  1 74,  where  the 
public  charities  of  a  German  city  were  asked  to  seek  out  relatives, 
to  interest  them  in  a  case  of  distress,  to  get  their  advice  as  to  the 
best  method  of  treatment,  and  to  obtain  from  them  material  assis¬ 
tance.  All  of  this  was  asked  without  providing  them  with  any  data 
save  the  impressions  of  a  first  visit  supplemented  by  the  impres¬ 
sions  of  the  agency  that  referred  the  family  for  care.  The  family 
had  lived  in  the  same  American  city  for  eleven  years,  yet  no  his¬ 
tory  was  procured  before  setting  in  motion  a  process  which,  if  un¬ 
successful  in  its  outcome  the  first  time,  could  not  easily  be  repeated. 

321 


21 


SOCIAL  DIAGNOSIS 


The  inquirer  might  well  have  reasoned  as  follows:  The  public 
department  of  charities  in  a  large  German  city  has  many  inquiries 
from  America,  probably.  It  has  its  own  work  besides.  This 
matter  will  receive  only  perfunctory  attention  unless  I  can  show 
that  I  know  whereof  1  write.  The  relatives  of  this  woman  have 
not  seen  her  for  many  years,  probably,  and  about  her  life  in  America 
they  know  what  she  has  told  them.  I  must  seek  information 
covering  this  long  period  elsewhere,  and  out  of  the  clues  now  in 
my  hand,  must  construct  her  past  in  this  country  as  best  I  can. 
Since  I  shall  be  fortunate  if  I  get  one  reply  from  my  German  corre¬ 
spondent,  I  must  make  that  one  count  for  as  much  as  possible  in 
shaping  treatment  aright  by  letting  the  inquiry  overseas  grow  out 
of  the  history  nearer  at  hand.  But  the  line  of  reasoning  actually 
followed  would  appear  to  have  been  this:  It  will  take  several 
weeks  to  hear  from  Germany,  so  a  letter  must  be  written  at  once — 
the  visits  here  can  be  delayed.  Besides,  there  are  no  relatives  over 
here,  or  so  the  mother  of  the  family  says,  and  relatives  are  always 
the  best  references. 

3.  What  Relation  Does  This  Particular  Inquiry  Bear  to  the 
Whole  Process?  The  need  of  asking  this  further  question  is 
illustrated  by  the  letter  of  inquiry  just  referred  to.  It  is  also  illus¬ 
trated  by  many  letters  to  relatives,  copies  of  which  have  been  found 
in  the  case  records  studied.  Instead  of  showing  that  the  inquirer 
is  thinking  of  his  client's  life  as  a  whole,  of  the  great  gaps  in  his 
understanding  of  that  life,  and  of  the  kind  of  insight  that  the 
relative  would  best  be  fitted  to  give,  they  show  an  almost  auto¬ 
matic  drift  into  requests  that  the  brother  pay  a  month's  rent,  that 
the  grandfather  furnish  milk  for  the  baby,  that  a  homejbe  supplied 
for  a  family  of  six,  etc.  These  are  services  all  of^which  may  be 
appropriately  undertaken  by  relatives  under  certain  conditions, 
but  what  is  the  purpose  in  paying  the  rent  and  furnishing  the  trans¬ 
portation?  Permanent  betterment  presumably,  or  at,jdeast  some 
better  foothold,  some  more  effective  adjustment  for  the  client  or 
for  his  whole  family.  The  following  inquiry  shows  this  relating  of 
the  simple  question — the  question  of  willingness  to  receive  a  rela¬ 
tive — to  some  of  the  more  important  issues  involved.  The  reply 
is  given  on  p.  324. 

We  are  anxious  to  have  a  call  made  upon  Mrs.  Jane  Seymour,  who  lives  in  Bed- 

322 


LETTERS,  TELEPHONE  MESSAGES,  ETC. 


ford  [a  small  town  in  the  same  state  as  that  of  the  agency  addressed].  Will  you 
be  kind  enough  to  forward  this  letter  to  your  correspondent  there?  [The  enclosure 
read  as  follows:] 

We  have  become  very  much  interested  in  Arthur  Brown,  a  private  in  the  United 

States  Artillery  stationed  at  Fort - in  this  harbor.  He  comes  from  Bedford, 

where  his  mother,  stepfather,  and  brother  have  a  farm.  He  has  been  in  the  army 
nearly  three  years  and  has  five  more  months  to  serve.  Last  summer  he  married  a 
girl  in  this  city  whom  he  is  unable  to  support,  as  his  pay  is  only  $18  a  month.  Con¬ 
sequently  he  has  been  running  into  debt  ever  since  his  marriage  and  owes  about  $40. 
At  the  present  time  he  has  drawn  a  month’s  pay  in  advance.  He  tells  us  that  his 
mother,  Mrs.  Seymour,  is  very  willing  to  take  his  wife  and  baby  into  her  home.  We 
are  afraid  that  Mrs.  Brown  is  a  difficult  girl  to  get  on  with  and  for  that  reason  are 
particularly  anxious  to  know  whether  Mrs.  Seymour  is  a  tactful  and  intelligent 
woman. 

Can  you  send  someone  to  see  Mrs.  Seymour  and  can  you  find  out  anything  about 
the  family?  If  you  are  able  to  see  Mrs.  Seymour  will  you  tell  her  that  we  are  going 
to  help  Mr.  Brown  to  pay  his  wife’s  rent  until  we  hear  from  her?  If  this  address  is 
not  accurate  enough  will  you  please  let  me  know? 


This  letter  was  not  addressed  to  Mrs.  Seymour  herself  for  reasons 
that  are  evident;  the  inquiry  was  sent  through  two  intermediaries 
— through  a  family  agency  in  Mrs.  Seymour’s  state,  which  found 
a  correspondent  in  her  town  of  Bedford.  It  would  have  been  easy 
enough  to  write  to  Mrs.  Seymour  direct  and  ask,  Will  you  take 
your  daughter-in-law  and  grandchild  into  your  home?  But  it  was 
not  possible  to  ask,  Are  you  responsible  enough  and  tactful  enough 
to  care  for  a  girl  who  needs  especially  good  care?  Which  brings 
us  to  our  next  question. 

4.  Has  the  Best  Correspondent  Been  Chosen  for  the  End  in 
View?  The  real  end  in  view  must  be  clearly  grasped  before  this 
query  can  be  asked  or  answered*  It  must  be  confessed  that  the 
very  uneven  development  of  social  case  work  in  different  cities  and 
in  different  parts  of  the  country  often  reduces  the  inquirer  to 
Hobson’s  choice  in  the  matter  of  correspondents.  It  is  not  always 
possible,  for  instance,  to  avoid  direct  communication  by  mail  with 
the  Mrs.  Seymours,  and  certain  things  that  they  cannot  tell  us 
must  remain  unasked  and  unanswered.  In  choosing  the  method 
of  inquiry  through  an  intermediary,  moreover,  there  is  always  the 
risk  that  a  private  matter  may  be  made  public,  that  the  pride  of 
sensitive  people  may  be  wounded,  owing  to  lack  of  tact  and  discre¬ 
tion  in  the  intermediary  selected.  Nevertheless,  direct  replies  from 

323 


SOCIAL  DIAGNOSIS 


illiterate  witnesses  are  often  so  unsatisfactory,  and  the  observations 
and  estimates  of  an  intermediary  are  so  much  needed  that  this  risk 
has  frequently  to  be  taken. 

The  correspondent  found  in  Mrs.  Seymour’s  town  replied  as 
follows: 

I  have  just  received  the  report  of  the  chairman  of  our  investigating  committee 
of  the  case  of  Mrs.  Jane  Seymour,  as  requested  in  your  communication  of  the  18th. 
She  reports  Mrs.  Seymour  to  be  a  quiet,  modest  woman  of  average  intelligence  and 
fair  education,  who  she  judges  could  get  along  with  her  son’s  wife  if  she  is  at  all 
reasonable.  Mrs.  Seymour  is  a  woman  of  few  words,  a  good  housekeeper,  in  com¬ 
fortable  circumstances,  with  plenty  of  room  in  her  house  for  Mrs.  Brown,  and  she  is 
quite  willing  to  have  her  come  so  she  can  help  her  son  in  this  way  to  get  on  his  feet 
after  his  enlistment  expires.  She  said  she  did  not  have  money  to  send  for  Mrs. 
Brown,  but  could  and  would  take  care  of  her  until  her  son  was  able  to  take  care  of 

her  himself.  I  think  the - society  need  not  hesitate  to  send  Mrs.  Brown  to 

Mrs.  Seymour’s.  There  will  be  plenty  to  eat,  a  good  home,  with  wholesome  sur¬ 
roundings,  and  from  all  I  can  learn  a  thoughtful  woman  to  live  with  and  take  care 
of  her. 

This  is  not  the  report  of  a  trained  social  worker — it  is  not  so 
concrete  as  such  a  report  should  be — but  it  contains  a  general 
common-sense  estimate  by  a  kindly  householder,  and  this  estimate 
makes  the  answer  more  satisfactory  on  the  whole  than  direct  corre¬ 
spondence  could  have  been.  It  cannot  be  denied,  however,  that 
the  choice  between  direct  and  indirect  communication  is  a  difficult 
one  to  make,  and  one  requiring  tact  and  consideration.  The  letter 
of  inquiry  (p.  323)  speaks  of  Mrs.  Brown  as  “a  difficult  girl  to  get 
on  with.”  This  is  a  vague  description,  but  it  may  have  been  pur¬ 
posely  so  in  view  of  the  fact  that  the  correspondent  to  be  selected 
was  unknown  to  the  writer. 

One  letter  about  the  relatives  of  a  skilled  workman  known  to  be  drinking  heavily 
and  to  be  despondent  and  destitute  was  sent  to  an  overseer  of  the  poor  in  a  small 
town.  He  promptly  handed  it  to  the  man’s  brother  and  told  him  to  answer  it. 
The  kind  of  reply  thus  obtained  could  have  been  had  as  well  or  better  by  direct 
correspondence.  The  intermediary  had  failed  to  grasp  the  purpose  for  which  he  had 
been  called  in. 

Local  correspondents  can  be  secured  in  a  number  of  ways. 
Through  the  use  of  the  professional  directories  and  the  year  books 
described  in  the  chapter  on  Documentary  Sources  a  state  or  county 
official,  lawyer,  teacher,  physician,  or  clergyman  may  be  found  who 
may  prove  a  valuable  intermediary  in  an  important  inquiry.  When 

324 


LETTERS,  TELEPHONE  MESSAGES,  ETC. 


we  are  seeking  the  kind  of  information  likely  to  be  known  to  a 
local  merchant  or  manufacturer,  wholesale  houses  in  our  own  city 
may  have  correspondents  in  smaller  places  to  whom  they  can  give 
us  letters  of  introduction,  and  some  such  approach  might  be  found 
to  the  other  out-of-town  sources  mentioned  in  this  paragraph. 

Miss  M.  L.  Birtwell  writes1  as  follows  of  clergymen  as  corre¬ 
spondents: 

In  localities  in  which  we  have  no  regular  correspondent  we  may  use  some  local 
clergyman,  preferably  of  the  same  denomination  as  the  family  in  regard  to  whom  we 
are  inquiring.  Often  we  use  the  Episcopal  clergyman,  as  the  organization  of  that 
denomination  on  the  parish  system  gives  their  clergymen  a  sense  of  responsibility 
in  regard  to  any  need  within  parish  boundaries.  If  the  inquiry  is  to  be  made  in  a 
locality  of  which  we  are  entirely  ignorant,  we  have  sometimes  written  to  the  post¬ 
master,  enclosing  a  letter  which  he  is  requested  to  give  to  the  nearest  or  most  in¬ 
fluential  local  clergyman. 

Our  local  Home  for  Destitute  Children  once  asked  us  to  investigate  the  applica¬ 
tion  of  a  widow  for  the  admission  of  her  two  children  to  the  home.  Her  husband, 
she  said,  had  been  drowned  some  months  before  in  Nova  Scotia;  she  could  find  no 
work  there  by  which  she  could  support  herself,  so  had  come  to  a  sister  in  Cambridge 
in  the  hope  that  the  latter  would  care  for  her  children  while  she  went  out  to  work. 
The  sister  had  children  of  her  own,  however,  and  her  husband  would  not  consent  to 
the  additional  burden.  The  woman  said  she  had  a  place  at  a  restaurant  at  $5.00  a 
week,  which  she  would  lose  unless  she  could  get  her  children  cared  for  at  once.  We 
found  the  woman  with  her  sister  in  a  neat,  comfortable  home  with  every  appearance 
of  respectability,  but  she  seemed  unable  to  give  references  from  her  home  town. 
The  owner  of  the  mill  where  the  husband  worked  had  gone  out  of  business,  they 
had  lived  too  far  out  in  the  country  to  go  to  church,  so  knew  no  clergyman  well 
enough  to  give  his  name  as  reference,  etc.  We  advised  the  Home  against  hasty 
action  and  refused  to  make  any  recommendation  till  a  thorough  investigation  could 
be  made.  A  letter  was  at  once  written  to  the  local  Episcopal  clergyman,  asking 
him  to  look  up  the  family  history,  the  record  of  the  man’s  death,  and  resources  in 
the  way  of  work  for  the  woman.  A  prompt  reply  was  received  saying  that  the  man 
was  alive  and  well;  that  there  had  been  a  family  jar,  and  the  woman  in  a  fit  of 
temper  had  gone  to  the  States  to  visit  her  sister;  that  the  man  had  told  her  to  go  if 
she  wanted  to,  but  had  said  that  she  would  have  to  get  back  as  best  she  could.  We 
wrote  the  clergyman  to  stimulate  a  forgiving  spirit  in  the  man  and  urge  him  to 
send  at  least  part  of  the  fare  of  the  family,  and  promised  to  do  what  we  could  to 
help  the  woman  earn  her  share.  We  got  her  a  place  at  service  with  one  child,  the 
employer  knowing  it  was  a  temporary  arrangement,  leaving  the  other  child  with  her 
sister.  She  saved  her  wages  of  $2.00  per  week,  and  in  a  few  weeks,  with  her  hus¬ 
band’s  help,  the  traveling  expenses  were  met  and  the  family  reunion  took  place. 

An  exasperating  practice  of  some  social  workers  which  is  usually 

1  In  one  of  the  short,  unpublished  papers  referred  to  in  the  Preface. 

325 


SOCIAL  DIAGNOSIS 


without  excuse  is  to  write  directly  to  a  relative  or  other  witness, 
asking  for  advice  and  service,  and  at  the  same  time  to  write  to 
another  correspondent,  asking  that  the  person  thus  addressed  be 
seen,  without  mentioning  to  either  that  a  letter  has  been  sent  to 
the  other.  Presumably  the  idea  behind  this  procedure  is  that,  if 
either  source  fails,  time  will  have  been  saved  by  duplicate  inquiry. 
There  may  be  cases  in  which  both  letters  should  be  written,  but 
in  these  circumstances  both  correspondents  are  entitled  to  an 
explanation. 

Sometimes  a  client  will  suggest  that  he  himself  do  the  writing 
to  relatives  or  others  at  a  distance  who  know  him,  showing  the 
replies  when  received  to  the  case  worker.  Usually  this  is  not  a 
good  plan.  A  letter  of  reply  is  of  little  value  as  evidence  without 
the  contents  of  the  letter  to  which  it  is  an  answer,  and  moreover 
the  client’s  failure  (innocent  failure  often)  to  ask  the  right  questions 
may  cause  unnecessary  delays. 

The  choice  of  foreign  correspondents  has  always  presented  diffi¬ 
culties,  and  these  difficulties  have  been  increased  since  August, 
1914,  though  time  will  bring  better  adjustments,  of  course.  The 
following  general  suggestions  about  foreign  letters  are  made  by 
the  American  Association  of  Societies  for  Organizing  Charity: 

Letters  written  in  the  language  of  the  country  to  which  they  are  going  may  be 
addressed  to  the  mayor  of  the  town  or  to  the  parish  priest;  the  consul  in  your  city 
who  represents  this  country  may  be  willing  to  forward  a  letter  for  you  or  write  him¬ 
self  to  some  local  official;  inquiries  may  be  sent  to  the  American  Consul  in  the  city 
nearest  the  town  where  the  visit  is  to  be  made.  While  the  department  of  state  has 
stated  that  this  is  a  logical  service  for  the  consuls  to  render,  the  societies  have  not 
always  received  prompt  or  satisfactory  replies  from  them.  In  France  and  Italy 
the  mayor  of  the  town  has  proved  to  be  the  best  source  of  information. 

5.  What  Will  Interest  the  Correspondent  Selected?  An  intel¬ 
ligent  choice  of  out-of-town  sources  of  information  follows  as  far 
as  possible  the  line  of  their  natural  interests.  A  kindly  woman, 
herself  a  householder,  can  enter  more  fully  than  many  another  into 
the  deeper  meanings  of  the  request  made  of  Mrs.  Seymour  (p.  322) 
that  she  receive  an  unknown  daughter-in-law  into  her  home.  A 
clergyman  is  fulfilling  one  of  the  true  functions  of  his  pastorate 
when  he  seeks  to  stimulate  a  forgiving  spirit  between  husband  and 
wife  (p.  325).  This  was  not  the  first  request  made  in  this  instance, 
but  family  estrangement  is  suggested  by  the  story  of  a  woman 

326 


LETTERS,  TELEPHONE  MESSAGES,  ETC. 

of  apparent  respectability  who  will  give  not  a  single  clue  to  sources 
of  information  in  her  home  town.  The  looking  up  of  records  was 
only  preliminary  to  the  real  task  developed  by  the  facts  of  the  case. 
This  longer  view  not  only  helps  in  the  choice  of  correspondents, 
but  it  enables  us,  in  writing  to  them,  to  leave  a  window  open,  to 
suggest  a  prospect  beyond  the  immediate  details  about  which  we 
are  concerned.  It  is  this  prospect,  this  relating  of  small  details  to 
helpful  and  constructive  results  in  the  near  future,  that  will  most 
surely  interest  them  in  our  request,  and  fire  them  with  a  desire  to 
have  a  share  in  this  particular  social  undertaking.  Not  many 
words  will  be  necessary,  but  something  of  our  real  interest,  some¬ 
thing  more  than  mere  processes,  must  be  suggested. 

The  avoidance  of  technical  terms,  a  choice  of  words  at  once 
direct  and  human,  an  ability  to  think  imaginatively  of  our  task 
and  to  convey  its  large  spirit  of  service  to  our  correspondent — 
these  are  methods  that  emphasize  the  need  of  varied  approach, 
for  no  one  form  of  approach  will  interest  all  correspondents  equally. 
It  is  worse  than  folly  to  write  to  the  prosperous  father  of  a  way¬ 
ward  son — to  a  father  who  might  have  been  not  only  the  most 
valuable  single  source  of  information  but  the  best  of  co-operators — 
and  seek  to  interest  him  by  saying,  “  We  are  very  anxious  to  obtain 
the  previous  record  of  this  young  man/'  One  such  inquiry,  to 
which  reference  has  been  made  earlier,  brought  no  reply,  and  the 
following,  also  found  in  a  case  record,  did  not  deserve  one:  “  I  am 
anxious  to  have  your  advice  about  your  brother,  John  Smith,  now 
in  this  city.”  This  was  the  entire  letter,  but  extreme  prolixity  is 
quite  as  bad.  A  letter  that  is  practically  a  case  record  summary 
and  a  chronological  one  at  that  may  be  serviceable  as  part  of 
another  social  agency’s  case  record,  but  it  will  never  interest  a 
correspondent. 

Every  little  while  someone  proposes  that,  in  order  to  systematize 
out-of-town  inquiries,  they  should  all  be  centralized,  should  be 
handled  for  each  community  by  some  one  agency.  The  maximum 
of  interest  will  never  be  developed  in  this  way,  however,  and  it  is 
likely  that  order  can  be  introduced  into  our  inquiries  by  some  other 
plan  not  so  liable  to  destroy  their  serviceableness. 

6.  What  Presentation  Will  Save  the  Correspondent  Unneces¬ 
sary  Trouble?  Every  witness  from  whom  we  seek  co-operation 

327 


SOCIAL  DIAGNOSIS 


should  be  assumed  to  be  socially  minded  and  willing  to  do  his  fair 
share  until  there  is  conclusive  proof  to  the  contrary.  He  is  en¬ 
titled,  therefore,  to  protection  from  annoying  publicity.  Inquiries 
should  not  be  sent  on  post  cards,  and  in  small  places,  or  in  neigh¬ 
borhoods  in  which  our  letters  may  be  handled  by  gossiping  fellow 
tenants,  they  should  have  only  a  return  address  printed  on  the 
outside  instead  of  the  full  name  of  the  social  agency. 

Whatever  data  will  aid  in  the  full  identification  of  our  client  and 

* 

of  the  places  or  people  locally  involved  in  his  story,  whatever 
details  will  make  clearer  the  items  to  be  verified  or  discovered,  will 
surely  save  time  in  the  long  run  for  the  inquiring  agency.  But  even 
more  important  is  the  consideration  that  a  clear  setting  forth  of 
these  things  in  the  original  inquiry  will  save  unnecessary  annoy¬ 
ance  to  the  correspondent,  will  further  excite  his  interest,  and  will 
make  him  a  more  competent  reporter,  whether  of  his  own  first¬ 
hand  information  or  of  the  data  obtained  by  visits  made  at  our 
request. 

In  writing  to  relatives,  for  instance,  it  is  not  enough  to  dwell  upon 
the  specific  things  that  we  wish  to  know,  or  even  to  suggest  the 
future  helpful  uses  to  which  their  information  will  be  put.  Rela¬ 
tives  are  often  consumed  with  anxiety  to  know  just  what  has  been 
happening  lately,  and  what  are  the  present  circumstances  of  one 
from  whom  they  have  not  heard  in  a  long  while.  Our  statements 
should  be  specific  rather  than  general,  moreover,  though  they 
should  not  be  technical.  This  applies  also  to  letters  in  which  we 
ask  a  correspondent  to  see  relatives. 

A  family  agency  found  a  man  ill  in  the  almshouse  hospital  with  tuberculosis,  who 
confessed  to  a  prison  term  for  forgery.  Though  he  told  thus  much,  he  gave  the 
agency  an  assumed  name  and  added  a  false  address  for  his  immediate  family  in  a 
distant  city.  A  kindred  agency  there  was  asked  to  visit.  They  could  not  find  the 
man’s  family  at  the  address  given,  but  did  find  the  firm  of  employers  whose  check 
he  said  that  he  had  forged.  All  knowledge  of  him  or  of  the  circumstances  was 
denied,  however,  by  the  clerk  in  charge  at  this  establishment,  until  mention  was 
made  of  the  fact  that  the  man  was  now  very  ill.  The  clerk,  who,  it  appears,  was  an 
old  chum,  immediately  became  alarmed,  told  the  sick  man’s  real  name,  and  took 
the  case  worker  making  the  inquiry  to  the  family’s  right  address.  The  visits  made 
in  this  case  would  have  been  of  no  avail  without  the  mention  of  the  client’s  present 
condition  contained  in  the  letter  of  inquiry. 

An  associated  charities  was  asked  to  see  the  relatives  of  a  one-legged  man  who, 
with  his  family,  was  destitute  in  a  distant  city.  It  replied  that  these  relatives  re- 

328 


LETTERS,  TELEPHONE  MESSAGES,  ETC. 


fused  to  be  interviewed  or  to  give  any  information.  The  inquiring  agency  wrote 
again,  giving  more  details  and  asking  more  specific  questions,  but  with  no  better 
result.  When  the  agency  protested  to  a  referee  later  about  what  seemed  to  be 
poor  inquiry  work  on  the  part  of  its  correspondent,  the  referee  replied  in  part  as 
follows: 

Without  knowing  anything  more  than  the  letter  reveals,  it  seems  to  me  possible 
that  the  unwillingness  of  the  Jacks  family  in  Wickford  to  give  any  information,  and 
the  unwillingness  of  the  Wickford  society  to  push  an  already  exasperated  relative 
further  at  the  present  time  may  be  due  to  the  fact  that,  doubtless  through  hurry 
or  some  oversight,  you  failed  to  ask  any  of  the  questions  in  your  first  letter  that  you 
did  ask  in  your  second.  The  visitor  of  the  Wickford  Associated  Charities  had  a 
commission  from  you  to  find  out  whether  the  Wickford  relatives  would  contribute 
toward  the  purchase  of  a  new  leg.  This  was  a  perfectly  concrete  demand  upon 
them  which  seems  to  have  brought  an  indignant  response.  In  my  own  experience 
it  is  a  mistake  to  begin  an  approach  to  relatives  with  a  demand  for  service  on  their 
part.  The  initial  demand  should  be  for  advice  and  any  experience  of  theirs  that  will 
increase  your  own  insight.  It  is  very  clear  that  you  realize  some  of  this,  or  you 
would  not  have  written  the  questions  contained  in  your  second  letter,  but  unfor¬ 
tunately  they  came  rather  late  and  after  the  damage  had  been  done.  ...  In 
your  first  letter  you  do  not  even  supply  Jacks’  first  name,  and,  upon  reading  the 
two  letters  side  by  side,  I  think  you  will  agree  with  me  that  your  second  would  have 
been  a  much  better  guide  to  anyone  visiting  the  Wickford  relatives  for  the  first 
time  than  your  first  letter  was. 

One  letter  of  inquiry  reads  as  follows:  “Will  you  kindly  forward  the  following 
information  to  your  correspondent  in  Cranford?  James  Harvey,  American,  aged 
thirty-three,  came  to  us  this  morning  to  obtain  work.  His  mother,  Mrs.  Kate 
Harvey,  lives  at  20  Saunders  Street,  Cranford,  with  her  married  daughter.  There 
are  several  other  brothers  and  sisters  of  Mr.  Harvey,  and  we  would  like  to  find  out 
if  they  are  able  to  give  him  some  assistance. 

“Will  you  also  look  up  the  following  business  references  for  Mr.  Harvey?  He 
has  worked  for  the  Cranford  Tunnel  Company  and  for  the  Electric  Works  as  wire- 
man.  During  the  past  winter  he  says  that  he  was  ill  in  the  Cranford  Hospital  with 
hemorrhages  of  the  stomach.  Any  information  which  you  may  obtain  for  us  will 
be  greatly  appreciated.” 

About  which  the  case  worker  responsible  for  the  inquiry  in  Cranford  writes: 
“There  is  no  explanation  here  as  to  how  Harvey  came  to  the  society,  what  his  plan 
for  himself  is,  how  he  is  being  cared  for — in  fact  nothing  that  has  any  human  in¬ 
terest.  When  the  mother  was  interviewed,  she  began  to  ask  questions  which  we 
were  unable  to  answer.  The  mother  felt  and  expressed  herself  as  unable  to  suggest 
anything  unless  she  had  further  information,  and  the  interview  was  a  failure  from 
every  angle.” 

Another  letter  of  inquiry  to  a  kindred  agency  out  of  town  describes  the  present 
situation  of  a  family  quite  fully  and  then  asks  that  visits  be  paid  to  a  tax  collector, 
a  minister,  a  trust  company,  a  farmer,  and  to  a  Mrs.  Carter  on  B  Street.  The 
street  is  several  miles  long,  and  neither  street  number,  first  name  of  woman,  nor  rela- 

329 


SOCIAL  DIAGNOSIS 


tion  to  the  family  written  about  was  indicated.  In  fact,  the  particular  information 
sought  of  each  informant  and  his  supposed  relation  to  the  case  were  not  named  in  a 
single  instance. 

The  following  is  a  better  example  than  any  given  so  far  of  the 
type  of  inquiry  which  saves  delay  and  trouble,  and  secures  socially 
valuable  results.  It  was  written  by  a  state  board  of  charity  to  a 
child-protective  agency  in  the  same  state. 

I  do  not  know  whether  you  are  the  proper  person  to  whom  to  address  the  follow¬ 
ing  inquiry,  but  if  you  are  not,  I  trust  you  will  forward  my  letter  to  the  appropriate 
society. 

We  are  interested  in  a  girl  named  Jessie  Smith,  who  is  at  the  State  Institution  at 
Fairview.  She  was  sent  there  by  the  House  of  the  Good  Shepherd  of  Preston  for 
confinement.  She  had  been  arrested  in  Knightsbridge  and  put  on  probation  for  a 
year,  the  year  to  be  spent  at  the  House  of  the  Good  Shepherd.  She  entered  Fair- 
view  on  September  2,  1910,  and  her  child  was  born  about  the  middle  of  November. 
Her  year  on  probation  will  not  be  completed  until  the  latter  part  of  this  month, 
January,  but  the  Sisters  had  no  way  of  taking  care  of  a  woman  with  a  baby,  and  so 
would  receive  Jessie  again  only  on  condition  that  her  child  was  taken  from  her  first. 
Neither  of  Jessie’s  two  sisters  nor  her  aunt  will  receive  the  mother  and  infant,  or 
even  the  baby  without  its  mother. 

The  doctors  at  Fairview  have  had  this  girl  under  observation  for  some  time.  She 
has  a  violent  and  ugly  temper,  provoked  by  trifles.  They  consider  that  it  is  quite 
possible  that  she  is  insane,  but  they  would  like  us  to  get  more  of  her  family  history 
to  help  them  in  their  diagnosis.  I  am  writing  to  ask  whether  you  will  not  assist  us 
by  getting  some  skilful  visitor  to  make  certain  inquiries  for  us. 

Jessie  tells  us  that  she  was  born  in  Franklin,  West  Virginia,  August  5,  1887;  that 
she  lived  in  that  city  with  her  father  for  fourteen  years.  Her  mother  died  when  she 
was  a  little  child.  At  fourteen  her  father  placed  her  in  the  Industrial  School  of  that 
state  at  Perry,  and  she  remained  there  for  seven  years — until  she  was  twenty-one. 
This  school  is  a  reform  school.  When  twenty-one  she  was  placed  out  in  Jefferson, 
near  Perry,  by  the  Industrial  School.  From  there  she  was  shortly  taken  by  a  Rev. 
Mr.  Baer  of  Clayton  in  this  state.  Mr.  Baer  had,  as  I  understand,  brought  up  her 
sister  Jane  (Mrs.  Albert  Dawson,  Exeter  Street,  in  your  town)  and  so  was  anxious 
to  take  Jessie,  Jane  in  the  meantime  having  married.  Jessie  stayed  with  Mr. 
Baer  a  year  and  then  went  to  be  with  Mrs.  Dawson.  From  there  she  came  down  to 
Beaufort  to  stay  with  her  aunt,  and  later  returned  to  the  eastern  part  of  the  state. 
She  worked  as  a  waitress  for  a  Mrs.  Jenkins  who  runs  a  dining  room  for  your  girls’ 
seminary,  and  was  also  a  waitress  for  a  time  at  the  Eastern  Hospital. 

Can  you  put  on  foot  an  inquiry  of  Mrs.  Jenkins;  of  the  Eastern  Hospital;  of 
the  police  in  Knightsbridge;  and  of  the  sister,  Mrs.  Dawson?  We  should  be  glad 
to  know  how  good  a  worker  she  is,  why  she  left  her  places,  and  how  she  conducted 
herself.  And  of  the  sister  we  should  like  to  know  whether  there  is  anything  in  her 
inheritance  which  would  explain  her  possible  insanity.  She  told  me  that  her  father 
lives  in  California  because  of  asthma,  but  she  also  said  that  he  had  had  a  cough  for 

330 


LETTERS,  TELEPHONE  MESSAGES,  ETC. 

many  years.  If  there  is  any  other  taint  in  the  family,  such  as  alcoholism  or  epilepsy, 
this  or  tuberculosis,  according  to  the  present  opinion  of  doctors,  might  be  a  con¬ 
tributing  cause  of  mental  disorder.  Some  uncle  or  aunt  may  show  the  taint,  even 
if  her  immediate  forebears  do  not. 

I  fear  that  I  am  asking  a  great  deal  of  you,  but  the  information  may  be  of  the 
greatest  value  to  us.  This  girl  is  certainly  not  normal,  and  I  know  I  don’t  need  to 
say  to  you  how  almost  hopeless  it  is  to  try  to  get  such  a  girl — plus  a  baby — estab¬ 
lished  respectably.  For  the  sake  of  the  child,  and  of  future  children  that  ought  not 
to  be  born,  we  want  to  do  everything  we  can  towards  having  this  mother  committed. 
We  shall  ourselves,  of  course,  get  the  information  from  Clayton  and  Beaufort. 

7.  What  Facts  relating  to  the  Correspondent’s  Occupation, 
Education,  etc.,  Should  Modify  the  Approach  by  Letter?  Where 
a  correspondent  is  personally  known  to  us,  we  have  a  definite 
advantage  in  our  choice  of  method  of  approach,  but  often  our  only 
guides  are  a  few  stray  facts  as  to  his  occupation,  his  educational 
advantages,  and  his  alleged  relation  to  the  client  about  whom  we 
write.  We  fall  back  upon  these  slender  clues  because  we  lack  an 
intermediary  whose  point  of  view  is  known,  whose  discretion  can 
be  trusted,  and  whose  face-to-face  intercourse  with  the  witness  can 
overcome  our  own  handicaps. 

Letters  to  business  men  should  be  as  brief  as  is  possible  without 
sacrificing  definiteness  and  clearness.  Letters  to  former  employers 
of  a  client  should  give  his  name  in  full  accurately,  and  state  definite 
dates  and  the  exact  kind  of  information  sought,  while  at  the  same 
time  explaining  the  reason  for  the  inquiry  in  such  a  way  as  to  create 
no  unreasonable  prejudice.  Where  the  client’s  service  has  been  of 
a  personal  kind,  involving  direct  daily  contacts  with  the  corre¬ 
spondent,  the  letter  can  safely  be  more  personal. 

Inquiries  of  physicians  have  been  considered  in  the  chapter  on 
Medical  Sources.  It  may  be  repeated  here,  however,  that  no  letter 
asking  for  a  medical  diagnosis  should  attempt  to  give  one,  that  the 
relation  of  medical  diagnosis  to  the  social  treatment  of  which  the 
letter  of  inquiry  is  a  part  should  be  made  clear,  and  that  family 
history  and  the  specific  circumstances,  acts,  etc.,  that  might  have 
a  bearing  upon  medical  diagnosis  should  be  stated.  To  say  that 
we  think  our  client  is  mentally  deranged  is  futile;  to  state  the  ob¬ 
servations  that  have  created  this  impression  is  a  possible  help. 

A  worker  in  a  public  agency  for  the  blind  whose  work  is  statewide 
takes  for  granted,  in  writing  to  priests  about  their  parishioners, 

33i 


SOCIAL  DIAGNOSIS 


that  they  have  a  deep  interest  in  the  things  she  is  trying  to  accom¬ 
plish.  In  her  experience,  the  interest  already  exists  or  is  very  easily 
aroused,  and  her  letters  usually  convey  a  recognition  of  this  fact. 
The  following  is  a  characteristic  beginning: 

“You  probably  will  be  glad  to  know  that,  learning  of  a  child  in  your  parish  who 
has  inflammation  of  the  eyes,  I  went  to  see  her  and  found  the  family  willing  to  let 
the  child  come  to  the  city  and  attend  the  Eye  Hospital.”  And  this  is  a  char¬ 
acteristic  letter  ending:  “Remember  me  should  you  hear  of  one  who  is  blind  or  in 
danger  of  becoming  so.  I  should  like  not  only  to  do  what  I  can  to  help  them,  but, 
in  doing  for  your  parishioners,  to  be  able  to  serve  you.” 

This  same  worker,  in  addressing  the  parents  of  a  client,  always 
puts  the  names  of  both  on  the  outside  of  the  envelope  as  well  as 
on  the  enclosure,  doing  this  in  order  to  make  both  parents  feel  an 
equal  responsibility  for  answering  her  inquiries  and  for  carrying 
out  her  suggestions. 

A  case  worker  in  a  children’s  agency  once  said,  after  looking  over 
a  group  of  letters  addressed  by  workers  in  another  agency  to  a 
wayward  girl,  that  they  were  so  dignifiedly  and  elegantly  expressed 
as  to  make  her  hesitate  to  show  her  own.  She  was  accustomed, 
when  writing  to  uneducated  people  personally  known  to  her,  to 
address  them  in  simple  and  familiar  language,  some  of  it  almost 
childish.  It  may  be  questioned  whether  letters  of  inquiry  to  simple 
folk  are  always  intelligible  to  them.  Short  words  and  sentences, 
and  an  ability  to  see  both  the  form  and  the  content  of  the  letter 
through  the  eyes  of  the  receiver  would  bring  better  results.  Even 
the  form  of  the  letter — its  typewriter  script  on  official  letter  paper 
— may  put  a  barrier  between  its  writer  and  the  least  businesslike 
of  his  correspondents;  a  letter  written  by  hand  on  unofficial  paper 
sometimes  makes  a  better  beginning. 

Sometimes,  on  the  other  hand,  a  formal  rather  than  a  familiar 
tone  is  justified  by  the  nature  of  the  contents.  This  is  true  in  the 
following  to  a  father  from  a  child-protective  agency: 

“A  complaint  has  come  to  this  office  that  you  are  not  properly  providing  for  the 
support  of  your  wife  and  minor  child,  that  most  of  your  time  you  are  idle,  that  your 
wife  is  obliged  to  go  out  to  work  leaving  your  child  in  the  care  of  your  mother.  I 
called  at  your  home  yesterday  to  talk  this  matter  over  with  you,  found  the  house 
empty  and  the  door  unlocked.  The  outside  appearance  was  very  disorderly  and 
dirty.  1  would  like  to  hear  your  side  of  the  story  and  would  be  glad  to  have  you 
call  at  this  office  Saturday  morning  at  io  o’clock.”  The  recipient  did  not  come,  but 

332 


LETTERS,  TELEPHONE  MESSAGES,  ETC. 

went  to  work  the  next  day  and,  a  month  later,  was  found  to  be  still  working  steadily 
and  doing  better  in  every  way. 

In  all  of  the  foregoing,  emphasis  has  been  put  upon  letters  to 
those  who  are  not  themselves  engaged  in  social  work.  When  we 
are  writing  to  social  agencies,  our  statements  must  be  full  enough 
to  enable  them  to  co-operate  intelligently.  If  we  are  writing  about 
a  family,  the  names  and  ages  of  all  its  members,  the  wife’s  maiden 
name,  and  the  husband’s  full  name  (even  though  deceased)  should 
be  given.  In  asking  to  have  an  employer  visited,  do  not  omit  to 
mention  the  approximate  dates  of  employment,  the  kind  of  work 
done,  and,  if  a  large  firm,  the  department  in  which  the  worker  was 
employed,  his  work  number,  and  the  name  of  his  foreman.  When 
marriages,  births,  or  deaths  are  to  be  verified,  always  give  the  dates. 
Dates  should  be  given  also  for  the  period  of  residence  when  insti¬ 
tutional  connections  are  to  be  looked  up  or  former  addresses  are 
to  be  visited.  When  addresses  are  given  us  it  is  an  easy  matter, 
before  asking  an  out-of-town  agency  to  visit,  to  discover  whether 
the  addresses  are  at  all  possible  by  consulting  the  nearest  file  of 
out-of-town  city  directories,  or  the  nearest  set  of  street  guides  for 
other  cities. 

“When  I  have  a  name  given  me  without  the  street  address/'  writes  a  family 
case  worker,  “and  I  want  to  ask  another  society  to  investigate  for  me,  I  have  been 
able  to  give  the  exact  address  by  consulting  the  directory  of  that  city,  so  1  do  not 
often  ask  for  investigations  at  addresses  that  do  not  exist.  Recently  I  had  a  client 
who  said  that  his  brother-in-law  had  a  restaurant  in  Los  Angeles,  and  he  gave  the 
street  address.  Instead  of  writing  to  a  Los  Angeles  social  agency  and  waiting  two 
weeks  for  their  reply,  I  went  into  our  board  of  trade  rooms  and  consulted  the  di¬ 
rectory.  I  could  not  find  either  the  brother-in-law’s  name  or  that  of  the  street. 
When  my  client  found  that  I  could  not  accept  all  of  his  first  story,  he  told  me  the 
true  one.”  1 

The  time  of  social  case  workers  in  other  cities  is  quite  as  valuable 
as  our  own.  More  care  in  calling  upon  them  for  service,  a  clearer 
realization  of  the  uses  to  be  made  of  that  service,  and  a  better 
statement  of  our  own  case  would  greatly  enhance  the  value  of 
information  received  from  these  sources. 

III.  LETTERS  OF  REPLY  TO  INQUIRIES 

The  quality  of  a  letter  of  inquiry  has  much  to  do  with  the  full¬ 
ness  and  satisfactoriness  of  the  reply.  For  this  reason  more  space 

1  For  use  of  directories  see  also  Chapter  XIII,  Documentary  Sources. 

333 


SOCIAL  DIAGNOSIS 


has  been  given  to  this  first  half  of  letter  writing.  The  second  half, 
which  we  must  consider  only  in  so  far  as  it  relates  to  the  replies  of 
social  case  workers — to  the  letters,  that  is,  in  which  they  send 
information  already  at  hand  and  those  others  in  which  they  send 
information  secured  especially  for  the  inquirer — need  not  detain 
us  long.  The  worst  failings  of  such  letters  of  report  are  traceable 
to  failings  in  the  investigations  themselves,  but  some  few  are  due 
to  faults  of  the  social  diagnostician  as  correspondent. 

In  the  first  place,  his  letters,  like  those  of  other  modern  cor¬ 
respondents,  often  contain  internal  evidence  that  they  have  been 
written  in  reply  to  inquiries  that  have  not  been  read,  or,  if  read, 
have  not  been  fully  apprehended.1  It  follows,  in  the  second  place 
then,  that  his  reply  fails  to  cover  all  the  points  raised.  When  it  is 
impossible  to  cover  them  he  could  at  least  indicate  the  items  not 
supplied  and  the  reasons  for  the  omission.  This  precaution  would 
save  the  annoyance  of  further  inquiries,  further  replies,  apologies, 
etc.,  with  all  their  avoidable  delays.  In  the  third  place,  he  gives 
too  often  only  the  inferences  drawn  from  information  gathered, 
whereas  the  information  itself,  with  its  source  or  sources  and  some 
evaluation  of  the  witnesses  quoted,  is  needed.  The  inferences  are 
useful  too,  bu,t  they  should  be  recognized  and  stated  as  such,  thus 
giving  the  inquirer  a  chance  to  use  his  own  judgment.  Statements 
such  as,  “  I  am  informed,”  “  I  understand,”  without  saying  by  or 
from  whom,  leave  the  mind  confused  and  unsatisfied.  What  is 
said  elsewhere2  about  the  use  of  general  terms  in  case  records 
applies  to  letters  also. 

Letters  of  report  to  correspondents  in  the  same  city  are  easily 
followed  by  directer  communication,  which  supplements  or  cor¬ 
rects  their  deficiencies.  There  is  something  so  tangible  about  a 
letter,  however,  that  an  error  may  survive  the  correction  and  make 
trouble  a  good  deal  later. 

1  “  My  dear  old  grandfather.  .  .  taught  me  never  to  attempt  to  answer  a  letter 
without  placing  it  before  me  and  reviewing  it  scrupulously,  paragraph  by  para¬ 
graph.  Hundreds  of  times  have  I  devoutly  blessed  his  memory  for  that  lesson  in 
the  common-sense  of  correspondence.” — Anonymous  Contributor  in  the  Atlantic 
Monthly,  June,  1913,  pp.  856-7. 

2  See  p.  349. 


334 


LETTERS,  TELEPHONE  MESSAGES,  ETC. 

IV.  SOME  TECHNICAL  DETAILS 

The  foregoing  sentence  might  seem  to  contain  an  argument  for 
destroying  letters  as  soon  as  their  immediate  purpose  had  been 
served.  In  one  family  agency  a  business  men’s  committee  recom¬ 
mended  that  all  correspondence  about  any  given  case  be  destroyed 
as  soon  as  the  case  was  “closed” — this  being  the  agency’s  technical 
term  for  the  discontinuance  of  treatment.  Medical  men  would 
have  seen  by  analogy  the  folly  of  this,  but  business  men  could  not, 
and  the  attempt  to  carry  out  the  decision  caused  endless  trouble. 
It  is  important  in  case  work  to  keep  all  letters  received  and  copies 
of  all  letters  sent  that  have  any  bearing  upon  case  diagnosis  and 
treatment.  The  originals  of  letters  written  by  a  client  who,  at  the 
time  of  writing  or  later,  suffers  from  some  form  of  mental  disease 
are  sometimes  important  items  in  the  diagnosis  of  the  disease.  This 
is  also  true  in  the  diagnosis  of  mental  defect,  but  there  are  equally 
important  inferences  to  be  drawn  from  the  letters  of  the  normal, 
such  as  their  fitness  for  certain  work,  their  degree  of  education,  etc. 
It  is  often  found  wise  to  preserve  copies  of  letters  not  addressed  to 
the  case  worker  but  shown  by  the  client  as  having  an  important 
bearing  upon  his  affairs.  One  child-protective  agency  is  accus¬ 
tomed  to  have  such  letters  copied  at  its  office  while  the  client  waits. 

Letters  of  inquiry  or  report  should  not  be  forwarded  by  the 
client’s  own  hand.  One  letter  so  sent  to  a  hospital  contains  the 
following  sentence :  “No  doubt  you  will  notice  at  once  upon  talking 
with  her  that  she  is  not  mentally  normal.”  Apart  from  the  danger 
of  suggesting  a  diagnosis,  it  was  a  mistake,  of  course,  to  send  this 
by  a  client.  The  report  should  have  gone  by  mail,  and  only  a 
short,  unsealed  note  of  introduction,  referring  to  the  letter,  should 
have  gone  by  hand. 

Letters  addressed  “to  whom  it  may  concern”  should  not  be 
written  at  all.  The  worthlessness  of  such  letters  has  already  been 
referred  to  (p.  177).  Circular  letters  of  inquiry  are  often  used  with 
good  results  in  cases  involving  the  discovery  of  the  whereabouts  of 
runaway  boys  or  of  adults  who  are  mentally  disturbed.  These 
forms  should  indicate  that  duplicates  are  being  sent  to  a  number 
of  places.  They  should  contain  a  careful  description  of  the  person 
sought  and  suggestions  as  to  the  kind  of  story  that  he  is  likely  to 
tell. 


335 


SOCIAL  DIAGNOSIS 


Another  very  useful  device  in  establishing  whereabouts  and  even 
identity  is  the  registered  letter.  The  special  delivery  letter  is  not 
so  good,  because  the  post  office  authorities  are  not  so  careful  to 
demand,  for  its  receipt,  the  signature  of  the  addressee  or  of  someone 
holding  his  power  of  attorney.  The  registered  letter  receipt  is  used 
as  evidence  in  court.  Here  its  signature  can  be  disputed,  of  course, 
in  which  case  the  handwriting  expert  may  have  to  be  called  in. 

One  medical-social  department  tried  to  find  the  mother  of  a  hospital  patient,  a 
child  who  was  on  the  dangerous  list.  A  letter  addressed  to  her  had  just  been  re¬ 
turned  “not  found.”  The  post  office  authorities  were  consulted,  with  the  practical 
guarantee  from  them  that  a  registered  letter  would  reach  her  in  two  days'  time.  It 
did,  in  a  suburb  several  miles  away  from  the  original  address. 

A  regulation  of  the  post  office  department  forbids  letter  carriers 
to  give  information  about  addresses,  but  it  is  possible  to  get  such 
information  higher  up  when  satisfactory  reasons  can  be  given  for 
seeking  it.  In  large  cities  application  can  be  made  to  the  division 
superintendents,  followed,  when  this  fails,  by  appeal  to  the  post¬ 
master  himself.  Any  supposed  irregular  use  of  the  mails  should  be 
reported  promptly  to  the  post  office  inspectors,  who  are  always 
ready  to  investigate  such  complaints. 

As  has  been  said  already,  a  letter  is  better  evidence  when  accom¬ 
panied  by  the  inquiry  to  which  it  is  a  reply.  A  letter  is  somewhat 
better  evidence  when  accompanied  by  the  addressed  and  post¬ 
marked  envelope  in  which  it  was  received.  In  the  case  of  letters 
returned,  the  envelope  marked  “address  not  found”  should  be 
saved.  It  is  evidence  that  the  attempt  to  find  has  been  made. 

V.  COMMUNICATION  BY  TELEGRAPH 

In  a  good  many  minor  matters,  where  necessary  details  can  be 
stated  briefly  and  where  promptness  rather  than  fullness  of  reply 
is  the  important  thing,  communication  by  telegraph  is  more  satis¬ 
factory  than  by  letter  alone.  A  telegraphic  dispatch  should  always 
be  followed  by  a  letter  the  same  day,  and  in  cases  in  which  this 
procedure  is  not  well  understood  and  therefore  taken  for  granted 
by  the  recipient,  the  dispatch  should  state  that  a  letter  is  on  the 
way.  The  follow-up  letter  should  contain  a  copy  of  the  dispatch, 
which  may  have  been  mutilated  in  transmission.  Sometimes,  when 
a  letter  alone  would  suffice  if  given  prompt  attention,  the  psycho- 

336 


LETTERS,  TELEPHONE  MESSAGES,  ETC. 

logical  effect  of  the  dispatch  is  to  assure  prompter  answer  of  the 
letter.  The  “  night  letter  ”  form  of  dispatch,  which  carries  50  words 
without  extra  charge,  is  often  better  than  a  letter  alone,  when  a 
correspondent  is  more  than  twenty-four  hours’  journey  away. 

A  large  group  of  social  agencies  (about  800  at  the  present 
writing)  use  a  telegraphic  code  in  matters  pertaining  to  the  trans¬ 
portation  of  their  clients  within  the  United  States.  The  prelimi¬ 
nary  inquiries  by  telegraph  that  often  precede  the  furnishing  of 
transportation  are  thus  made  at  lower  cost,  and  there  is  also  a  gen¬ 
eral  understanding  among  these  agencies,  which  are  all  signers  of 
a  “  transportation  agreement,”  that  such  inquiries  shall  take  pre¬ 
cedence  of  others  and  be  answered  with  especial  promptness.1 

VI.  COMMUNICATION  BY  TELEPHONE 

The  question  of  whether,  in  a  given  case,  the  long  distance  tele¬ 
phone  would  not  be  a  better  means  of  communication  than  the 
telegraph  is  one  that  must  be  answered  with  a  knowledge  of  all  the 
circumstances  of  each  inquiry  in  mind.  The  possibility  of  a  choice 
should  not  be  lost  sight  of,  however.  The  mere  existence  of  a  tele¬ 
graphic  code,  for  instance,  may  lead  the  signers  of  the  transporta¬ 
tion  agreement  to  use  it  when  some  other  means  of  communication 
would  be  better.  For  data  already  in  the  possession  of  the  one 
communicated  with,  the  telephone  response  is  prompter  and  fuller, 
though  it  is  not  always  accurately  received.  For  information  that 
must  be  gathered,  reply  by  telegraph,  with  all  its  shortcomings,  is 
better,  therefore,  and  especially  so  for  names,  numbers,  etc.  All 
such  data  should  be  repeated  by  letter,  however,  when  originally 
communicated  either  by  telephone  or  by  telegraph.  The  prompt¬ 
ness  of  the  long  distance  telephone  in  putting  us  in  communi¬ 
cation  with  those  who  already  know  is  illustrated  by  the  following 
instances,  the  first  supplied  by  Miss  Alice  Higgins  (Mrs.  Wm.  H. 
Lothrop),  and  the  second  by  Miss  M.  L.  Birtwell: 

A  business  man  asked  us  to  send  a  young  fellow  to  his  father  in  a  city  200  miles 
distant,  and  thought  us  a  bit  fussy  when  we  talked  over  a  long  distance  telephone 
to  learn  if  such  return  would  help  the  man.  We  learned  the  father  was  a  chronic 
drunkard  and  a  most  undesirable  guardian,  but  that  an  uncle  in  an  adjoining  city 
to  our  own  would  be  a  wise  and  interested  adviser.  Consultation  with  the  uncle 

1  See  pamphlet,  Passing  On  as  a  Method  of  Charitable  Relief.  New  York,  Rus¬ 
sell  Sage  Foundation,  1911. 

22 


337 


SOCIAL  DIAGNOSIS 


resulted  in  a  good  position  and  a  home  for  the  nephew;  and  the  business  man  then 
appreciated  that  knowledge  before  action  meant  wiser  action. 

A  man  of  fifty-three  wandered  into  our  office  one  morning  at  about  1 1  o’clock 
and  asked  for  work.  He  did  not  seem  strong  or  intelligent  and  we  felt  that  he  was 
hardly  a  promising  subject  for  the  labor  market.  We  could  get  little  out  of  him, 
but  on  rather  close  questioning  he  mentioned  Palmer  as  a  recent  place  of  residence. 
Knowing  that  the  State  Hospital  for  Epileptics  was  located  there,  we  telephoned 
to  the  State  Board  of  Insanity  to  inquire  whether  such  a  man  had  been  a  recent 
inmate.  The  reply  came  that  according  to  report  from  that  hospital  a  man  of  that 
name  had  left  the  institution  two  days  before.  A  telephone  message  to  Palmer, 
eighty-four  miles  away,  brought  word  from  the  superintendent  that  the  man  had 
left  against  the  advice  of  the  authorities;  that  he  was  entirely  unfitted  to  earn  his 
living  out  in  the  community,  but  that  he  could  do  some  work  about  the  institution; 
and  that  they  would  like  us  to  use  our  utmost  efforts  to  persuade  him  to  return. 
He  refused  for  a  time  and  shed  tears  at  the  prospect;  but  after  much  kindly  per¬ 
suasion  on  the  part  of  one  of  our  workers,  who  shared  her  lunch  with  him,  he  con¬ 
sented.  He  was  put  on  the  train  in  care  of  the  conductor,  the  superintendent  was 
telephoned  to  that  he  was  coming,  and  at  half-past  five  in  the  afternoon  he  was  in 
safe  hands  again.  He  wrote  us  a  day  or  two  later  that  the  doctor  met  him,  that  he 
had  a  good  bath  and  a  good  supper,  and  was  back  at  his  old  job  at  the  stable. 

As  a  means  of  communication  within  the  city,  especially  with 
other  social  agencies,  the  telephone  is  very  popular  among  case 
workers  and  will  probably  continue  to  be  so.  Its  dangers  and 
shortcomings  are  only  beginning  to  be  noted,  and  they  deserve 
enumeration  for  this  reason.  No  one  will  use  the  telephone  too 
little,  because  it  is  so  convenient,  but  the  facts  brought  to  light  in 
the  course  of  our  case  reading  should  lead  everyone  to  use  it,  in 
diagnosis,  with  more  caution. 

It  is  comparatively  easy  to  get  in  communication  with  even  a 
very  busy  person  over  the  telephone,  which  still  has  the  right  of 
way  in  household  and  office  alike.  But  this  very  fact  means  that 
the  one  telephoned  to  may  have  been  interrupted,  with  the  result 
that  he  is  somewhat  irritated  and  has  little  conscience  about  put¬ 
ting  off  the  interrupter  with  an  inadequate  and  hastily  expressed 
statement.  Are  the  ordinary  run  of  people  as  frank  in  their  tele¬ 
phone  intercourse  as  they  are  in  intercourse  face  to  face?  The 
question  is  not  without  interest.  When  an  attempt  is  made  to 
answer  it,  this  factor  of  interruption  will  have  to  be  taken  into 
account.  Another  consideration  will  have  to  be  the  fact  that  the 
one  telephoned  to  cannot  always  be  sure  of  the  identity  of  the 
person  at  the  other  end  of  the  wire.  How  can  he  know  that  this 

338 


LETTERS,  TELEPHONE  MESSAGES,  ETC. 


questioner  is  just  what  he  claims  to  be?  The  one  telephoning,  on 
the  other  hand,  cannot  know  who  is  in  the  same  room  with  his 
informant,  and  the  informant  cannot  always  be  sure,  unless  he  has 
a  private  wire,  who  else,  besides  the  people  in  the  room  with  him 
and  the  questioner,  may  be  listening  to  the  conversation. 

Two  other  elements  increase  the  chances,  not  of  suppression  or 
untruthfulness,  but  of  error.  Over  the  telephone,  as  we  now  know 
it,  proper  names  are  very  frequently  and  other  words  somewhat 
less  frequently  misunderstood.  In  case  work  this  is  a  serious  draw¬ 
back.  In  addition  to  this,  case  records  seem  to  show  that  the  eye 
helps  the  ear  in  noting  what  is  said,  and  that  telephone  conversa¬ 
tions  are  less  accurately  reported  on  our  records  than  are  personal 
interviews.  The  following  comments  and  case  items  illustrate 
these  drawbacks: 

A  critic  of  case  records  writes  of  one  as  follows:  I  should  say  that  the  telephone 
communication  with  the  minister  on  September  1 6  had  been  ill  advised.  With  a 
minister  who  does  not  understand  our  methods  one  of  two  systems  of  approach  is 
generally  advisable;  first,  and  preferably,  the  personal  conference;  second,  a 
letter,  possibly  followed  by  a  telephone  call.  Direct  approach  by  telephone  is 
pretty  risky  unless  we  know  our  people. 

The  husband  of  a  tuberculous  wife  asked  a  medical-social  department  to  com¬ 
municate  with  him  by  telephone,  when  necessary,  at  the  factory  where  he  worked. 
But  in  this  way  the  fact  that  his  wife  had  tuberculosis  became  known  there,  and  the 
fear  among  his  fellow  employes  that  he  might  infect  them  made  it  so  uncomfortable 
for  him  that  he  was  forced  to  leave. 

A  former  newspaper  reporter  became  the  client  of  a  certain  social  agency.  Soon 
after,  the  agency  received  a  telephone  message  purporting  to  be  from  the  night 
editor  of  a  daily  paper  asking  that  the  reporter’s  application  receive  immediate 
and  careful  attention,  and  that  whatever  inquiry  was  made  be  conducted  without 
inconvenience  to  him.  Seen  later  the  same  day,  the  night  editor  denied  all  knowl¬ 
edge  of  this  message.  Far  from  commending  the  reporter  in  any  way,  he  con¬ 
sidered  him  an  adventurer  and  “hold-up  man.” 

A  family  agency  was  asked  by  a  society  in  another  city  to  see  the  relatives  of 
one  of  its  clients  and  his  physician.  The  agency  telephoned  to  the  physician  to  find 
that  the  client’s  brother  was  in  his  office  at  the  time.  While  the  treatment  of  the 
case  was  not  hampered  by  this  fact,  it  made  an  additional  difficulty  for  the  brother, 
who  was  extremely  sensitive  about  the  client’s  misfortunes. 

A  child-protective  agency  operating  in  a  rural  area  reports  that,  in  the  small 
country  towns  included  in  its  district,  half  the  town  may  be  on  one  telephone  line, 
and  that  it  is  considered  an  innocent  and  legitimate  diversion  to  lift  the  receiver  and 
hear  all  about  one’s  neighbors.  This  is  especially  true  if  a  particular  neighbor  is 
known  to  have  had  a  visit  from  the  agency’s  case  worker. 

339 


SOCIAL  DIAGNOSIS 


The  registrar  of  one  of  the  confidential  exchanges  reports  that  a  hospital  tele¬ 
phones  each  morning  all  the  names  about  which  it  wishes  to  make  inquiry,  and  that 
a  written  report  is  sent  to  the  hospital  later  in  the  day  about  each  one,  indicating 
whether  it  is  known  or  unknown.  Usually  a  note  comes  from  the  hospital  still 
later  to  say  that  certain  of  the  names  previously  telephoned  were  misunderstood, 
and  that  the  correct  spelling  is  so  and  so.  Thereupon  the  exchange  often  finds  that 
these  names  about  which  “no  information”  ha^  been  reported  are  really  in  the 
exchange. 

The  use  of  the  telephone  to  obtain  medical  data  led  to  the  following  results  in  one 
Polish  family:  (i)  Dispensary  reported  by  telephone  after  examination  of  the  three 
children  that  Dominic  had  been  given  a  positive  diagnosis  of  tuberculosis.  (2) 
Three  days  later  a  visit  to  the  dispensary  brought  out  the  fact  that  this  diagnosis 
belonged  not  to  Dominic  but  to  Almena,  his  sister.  (3)  A  year  and  four  months 
later,  dispensary  telephoned  that  the  mother  of  the  family  had  an  advanced  case  of 
tuberculosis.  (4)  Three  weeks  later,  the  doctor,  when  seen  at  the  dispensary,  said 
that  she  had  an  early  case. 

A  family  was  referred  by  a  medical-social  department  to  an  associated  charities 
with  certain  data,  including  the  statement  of  the  man  of  the  family  that  he  was 
earning  $14  a  week.  The  society  visited  the  employer  and  reported  over  the  tele¬ 
phone  to  the  medical  agency  after  this  visit  (or  was  understood  to  have  reported) 
that  the  man  was  earning  $17  a  week  and  had  been  doing  so  for  the  last  six  years. 
As  a  matter  of  fact  the  record  of  the  associated  charities  quotes  the  employer  as 
saying  that  the  man  had  been  earning  $14  a  week  for  six  years  but  that  his  weekly 
wage  had  just  been  increased  to  $17.  The  record  of  the  medical-social  department 
did  the  man  unintentional  but  serious  injustice,  as  it  suggested  the  inference  that 
he  was  not  trustworthy.1 

Some  case  workers  are  so  unwilling  that  their  work  should  be 
represented  on  the  records  of  other  organizations  by  someone’s 
recollection  either  of  a  telephone  conversation  or  of  one  face  to  face 
that  they  always  offer,  when  information  is  requested,  to  send  a 
written  summary  of  what  they  know  instead.  If  inquirers  are  in 
special  haste,  they  make  a  brief  statement  at  the  time  and  send 
the  written  summary  for  purposes  of  verification  and  for  its  fuller 
and  more  carefully  considered  details.  Such  workers,  in  asking 
information  from  others — in  following  up  the  clues  supplied  by  the 
confidential  exchange,  for  instance — are  careful  to  ask  for  written 
summaries  from  those  agencies  which  prove,  when  telephoned  to, 
to  have  some  definite  information  to  give.  When  supplemented 

1  A  critic  points  out  that  this  same  error  in  reporting  or  recording  might  have  hap¬ 
pened  in  or  after  a  personal  interview,  though  there  are  more  errors  when  the  tele¬ 
phone  is  used. 


340 


LETTERS,  TELEPHONE  MESSAGES,  ETC. 


by  the  written  summary,  the  telephone  becomes  a  far  safer  means 
of  communication. 


SUMMARY  OF  THIS  CHAPTER 

1.  The  best  means  of  communication  for  most  case  work  purposes  is  the  personal 

interview;  the  worst  is  the  blank  form.  ^  „ 

I  I.  yf  ' 

2.  The  letter  of  inquiry  is  too  often  a  matter  of  routines  '  The  Value  of  such  a 
letter  may  be  tested  by  the  following  questions: 

✓ 

(1)  Should  the  letter  be  written  at  all  or  would  some  other  pieans  of  communica¬ 
tion  serve  the  purpose  better? 

(2)  Should  the  letter  be  written  now?  Have  the  preliminary  inquiries  that 
would  make  its  writing  the  logical  next  step  all  been  made? 

(3)  What  relation  does  this  particular  inquiry  bear  to  the  whole  process? 

(4)  Has  the  best  correspondent  been  chosen  for  the  end  in  view? 

(5)  What  will  interest  the  correspondent  selected? 

(6)  What  presentation  will  save  him  unnecessary  trouble? 

(7)  What  facts  relating  to  this  correspondent’s  occupation,  education,  etc., 
should  modify  the  approach  by  letter? 


3.  The  case  worker’s  letter  of  reply  to  an  inquiry  should  bear  internal  evidence 
that  the  inquirer's  letter  has  been  read  and  its  contents  fully  apprehended.  When 
it  is  impossible  to  cover  all  the  points  of  an  inquiry,  a  reply  should  name  the  items 
not  covered  and  give  reasons  for  the  omission. 


4.  A  letter  of  reply  to  an  inquiry  should  not  confuse  the  inferences  of  the  writer 
with  the  information  on  which  they  are  based.  The  letter  should  give  both,  but 
it  should  be  possible  for  its  recipient  to  distinguish  them. 

5.  A  telegraphic  dispatch  should  always  be  followed  by  a  letter  the  same  day; 
this  follow-up  letter  should  contain  a  copy  of  the  dispatch. 


6.  The  telephone  as  a  means  of  communication  in  case  work  is  too  convenient 
to  be  abandoned,  but  its  drawbacks  are  not  always  understood  and  guarded  against. 
There  are  good  reasons  why  people  are  not  so  frank  in  their  telephone  intercourse 
as  they  are  face  to  face,  nor  do  they  understand  what  is  said  as  well.  The  eye  aids 
the  ear  in  getting  names  and  numbers  accurately;  over  the  telephone  these  are  fre¬ 
quently  misunderstood. 


341 


CH  \PTER  XVIII 


COMPARISON  AND  INTERPRETATION 


WE  come  now  to  the  fourth  and  last  of  what  for  conve¬ 
nience  we  ha  /e  defined  as  the  stages  leading  to  diagnosis. 
Workers  will  continue,  in  many  cases,  to  find  their  way  to 
a  correct  and  sufficiently  amplified  diagnosis  without  consciously 
arranging  the  preliminary  steps  in  groups,  but  in  cases  presenting 
difficulties  they  will  find  this  separation  and  the  further  analysis 
attemp4ed4n4hi5-€hapter  an  aid  to  thinking.  The  processes  already 
described  have  been  (i)  the  first  full  interview  with  a  client,  (2) 
the  early  contacts  with  his  immediate  family,  (3)  the  search  for 
further  insight  and  for  sources  of  needed  co-operation  outside  his 
immediate  family. 

To  emphasize  the  essential  unity  of  these  three  processes,  to 
bring  out  a  few  of  their  salient  features  and  to  establish  more  clearly 
the  relation  of  these  to  the  final  process  of  Comparison  and  Inter¬ 
pretation  now4e~be~descnbed,  it  is  necessary  at-thisr-pomt  to  review 
briefly  a  part  of  the  ground  that  has  already  been  covered.  Since 
each  item  of  this  restatement  has  been  more  fully  developed  in 
earlier  chapters,  no  more  than  a  regrouping  of  the  main  ideas  is 
necessary. 


I.  CERTAIN  ASPECTS  OF  EARLIER  PROCESSES  RESTATED 
We  have  seen  (1)  that  certain  methods  and  points  of  view  are 
common  to  all  interviews,  (2)  that  different  types  of  interview  call 
for  changes  of  emphasis,  (3)  that  discrimination  in  the  choice  of 
outside  sources  of  insight  is  an  economy  of  time  as  well  as  an  indi¬ 
cation  of  skill,  (4)  that  the  risks  involved  in  different  types  of  evi¬ 
dence  and  the  nature  of  these  types  must  be  kept  in  mind  in  gather¬ 
ing  the  facts  and  in  weighing  them,  and  (5)  that  the  characteristics 
of  human  beings  as  witnesses  should  be  our  constant  study. 

1.  Methods  Common  to  All  Interviews.  Our  methods  and  point 
of  view  are  in  many  ways  the  same  whether  we  are  meeting  a  client 

342 


COMPARISON  AND  INTERPRETATION 


for  the  first  time,  visiting  members  of  his  immediate  family,  or 
seeking  insight  from  outside  sources.  In  all  these  cases  we  should 

(a)  Strive  to  procure  from  each  the  evidence  that  each  is  best 
able  to  give.  Some  facts  come  best  from  our  client,  some  from  our 
observation  of  his  home  surroundings  and  neighborhood,  some  from 
the  testimony  of  employers  and  comrades,  and  some  from  docu¬ 
mentary  sources. 

(b)  Utilize  any  natural  avenue  of  approach  to  a  client  presented 
at  the  beginning  of  the  interview,  and  as  the  interview  develops 
avoid  the  temptation  to  shape  it  in  accordance  with  preconceived 
ideas  of  its  probable  content.  The  same  caution  applies  to  any 
questions  that  we  may  have  to  ask — the  way  in  which  we  put  our 
question  should  not  suggest  the  answer. 

(c)  Give  the  person  interviewed  ample  time,  therefore,  in  which 
to  explain  his  own  point  of  view,  and  give  him  also  a  sympa¬ 
thetic  hearing. 

(d)  Keep  the  goals  of  fuller  knowledge  of  the  client’s  problem 

and  of  the  future  co-operation  of  relatives,  employers,  etc.,  in  its 

_ .?  ■ 

solution  always  in  view.  Our  ability  to  show  genuine  interest  will 
play  an  important  part  in  procuring  both  information  and  backing. 

2.  Changes  of  Emphasis  in  Interviewing.  Generally  speaking, 
we  are  justified  in  narrowing  our  inquiry,  somewhat,  as  we  approach 
the  sources  farthest  away  from  our  client’s  personal  life,  and  in 
broadening  it  in  our  talks  with  him  and  his  family.  As  between  the 
client  and  his  family  group  on  the  one  hand  and  certain  outside 
sources  on  the  other,  this  difference  becomes  a  marked  one.  In 
talking  with  our  client,  the  whole  man,  for  any  diagnosis  that  de¬ 
serves  to  be  called  social,  must  concern  us.  We  must  be  alert  to 
every  possible  clue  to  his  personality,  or,  in  other  words,  we  must 
note  the  current  of  events  in  his  life  as  well  as  his  social  relation¬ 
ships.  What  has  been  the  main  drift  of  that  current?  Who  are 
the  people  and  what  are  the  social  institutions  that  have  most 
influenced  him? 

To  win  these  insights  as  promptly  as  possible  without  endanger¬ 
ing  our  future  relations  with  him  we  must  avoid,  in  our  interviews, 
all  dictation,  hurry,  and  overquestioning;  we  must  give  our  client 
a  patient  and  fair  hearing,  merely  guiding  the  trend  of  talk  enough 
to  encourage  a  full  development  of  his  story. 

343 


SOCIAL  DIAGNOSIS 


This  same  painstaking  method  may  be  necessary  with  all  the 
members  of  the  client’s  family  group.  Knowledge  of  the  main 
drift  of  the  family  life  may  be  the  key  to  a  diagnosis  of  the  client’s 
situation.  In  studying  that  drift  it  will  be  found  useful  to  note  the 
difference  between  the  power  of  cohesion  in  a  united  and  in  an 
unstable  family. 

Passing  to  outside  sources,  we  find  some,  more  especially  those 
whose  relations  to  our  client  have  been  personal  and  unbroken, 
from  whom  we  shall  need  guidance  and  help  during  the  period  of 
treatment.  A  number  of  others,  however,  we  shall  see  only,  as  a 
rule,  before  our  diagnosis  is  made,  and  thereafter  not  at  all.  With 
these  latter  we  can  afford  to  save  time  by  narrowing  the  inquiry  to 
the  special  information  which  this  or  that  source  is  likely  to  supply, 
though  always  with  the  possibility  in  mind  that,  at  any  moment, 
the  person  interviewed  may  show  himself  able  to  throw  unexpected 
light  on  other  aspects  of  the  problem.  We  do  not  see  even  the  least 
important  outside  source  merely  for  verification  of  items  already 
learned  elsewhere;  verification  should  be  a  by-product  of  more 
fruitful  intercourse.  Success  in  the  interviewing  of  outside  sources 
depends  partly  upon  taking  time  to  explain  briefly  to  teacher,  phy¬ 
sician,  church  visitor,  etc.,  the  relation  of  the  items  of  information 
sought  from  him  to  the  constructive  work  which  is  in  process. 

It  is  evident  that  the  multiplication  of  interviews  in  which 
inquiry  is  thus  narrowed  may  be  carried  too  far.  If  undertaken 
heedlessly,  without  a  clear  conception  of  the  weaknesses  and 
strengths  of  the  evidence  already  gathered,  they  may  add  little  to 
our  sum  of  knowledge.  On  the  other  hand,  there  is  always  a 
degree  of  risk  in  omitting  any  source.  One  of  the  ways  of  econo¬ 
mizing  means  is  to  strive  to  get  from  sources  that  are  being  con¬ 
sulted  sidelights  upon  the  probable  value  of  those  that  have  not 

t  been  seen. 


3.  Discrimination  in  the  Choice  of  Outside  Sources.  Economy 
of  means  is  a  lesson  still  too  little  heeded  by  case  workers.  They 
should  beware,  it  is  true,  of  using  in  every  case  the  same  two  or 
three  kinds  of  source  and  no  more;  but,  in  choosing  varied  sources 


sician,  for  example,  the  employer  for  whom  a  client  worked  longest, 

344 


COMPARISON  AND  INTERPRETATION 


the  one  for  whom  he  worked  longest  during  the  last  five  years,  the 
previous  residence  at  which  his  family  lived  the  longest  during  the 
same  period,  the  social  agency  that  has  had  the  least  casual  con¬ 
tacts  with  his  family,  etc.  It  may  even  be  that  some  social  agency 
has  already  assumed  responsibility  for  treatment.  This  fact  would 
come  out  after  consultation  of  the  index  at  the  confidential  ex¬ 
change  or  social  service  exchange,  and  would  render  unnecessary 
further  work  with  the  client  in  question. 

Every  such  discrimination  gives  a  more  assured  and  economical 
use  of  sources.  Thus 

(a)  Some  sources  are  known,  even  before  they  have  been  seen, 
to  be  rich  in  history — they  are  familiar  with  our  client’s  early  life 
from  observation  instead  of  hearsay.  These  witnesses  may  or 
may  not  be  so  associated  with  the  client’s  present  as  to  be  likely 
to  be  rich  also  in  co-operation.  In  choosing  the  order  in  which 
sources  should  be  seen,  it  has  been  found  useful  to  see  first  those 
who  are  likely  to  be  rich  in  history  only,  in  order  that  our  first 
conference  with  a  possible  co-operator  may  be  conducted  later, 
when  we  can  meet  him  on  more  equal  terms  as  to  a  knowledge  of 
relevant  facts  in  the  client’s  history  and  therefore  with  greater 
likelihood  of  achieving  a  social  result. 

(b)  Another  useful  discrimination  is  that  between  clues  to  out¬ 
side  sources  obtained  from  a  client  or  his  immediate  family,  and 
such  clues  when  obtained  elsewhere.  The  latter  are  called  sup¬ 
plementary  clues,  and,  since  usually  they  have  been  revealed  more 
disinterestedly,  are  less  liable  to  be  prejudiced. 

(c)  A  further  discrimination  divides  social  agencies  as  witnesses 
into  those  agencies  that  have  had  a  personal  experience  with  our 
client  which  has  a  bearing  upon  diagnosis,  and  those  agencies  that, 
with  or  without  such  an  experience,  have  gathered  certain  objective 
and  fundamental  data  with  regard  to  the  client— data  which  are 
not  likely  to  change.  Previous  experience  of  the  work  of  certain 
social  agencies  may  serve  here  to  guide  us  to  those  that  usually 
gather  carefully  the  facts  of  family  and  personal  background. 

(d)  Still  another  discrimination  is  between  the  uses  to  which 
documentary  and  personal  sources  can  be  put.  The  impersonal 
document  is  more  satisfactory  for  objective  matters  of  fact,  such 
as  events,  dates,  places,  amounts;  and  individual  testimony  more 

345 


SOCIAL  DIAGNOSIS 


satisfactory  for  subjective  matters,  such  as  personal  traits,  in  which 
the  motives  and  capacity  of  the  witness,  the  atmosphere  and  spirit 
of  his  statement,  are  all  important. 

4.  Types  of  Evidence.  There  are  discriminations  to  be  made 
not  only  in  the  types  of  source  but  in  the  types  of  evidence  which 
sources  supply.  __  Real  evidence,  it  will  be  remembered,  is  the  very 
fact  at  issue  presented  to  our  senses.  .Testimonial  evidence  is  the 
assertions  of  human  beings,  to  which  must  always  Be~applied  tests 
of  the  competence  and  bias  of  the  witnesses.  Circumstantial 
evidence  is  any  indirect  evidence  whatsoever  which  tends  to  es¬ 
tablish  the  point  at  issue.  The  tests  applied  to  it  have  to  vary, 
because  the  subject  matter  is  infinitely  varied.  Any  fact  in  the  ma¬ 
terial  universe  or  in  the  mind  of  man  may  become  the  basis  from 
which  some  other  fact  is  inferred. 

There  is  an  important  distinction  in  testimonial  evidence  be¬ 
tween  the  assertions  of  those  who  say  that  they  saw  or  heard  the 
supposed  facts  themselves  and  the  assertions  of  those  who  have 
the  facts  only  from  what  others  have  told  them.  This  latter  is 
hearsay  evidence,  and  in  all  our  interviewing  we  should  discover 
the  extent  to  which  the  assertions  of  the  interviewed  are  founded 
on  observations  or  on  mere  rumor. 

5.  Characteristics  of  Witnesses.  The  first,  unrehearsed  state¬ 
ment  of  a  witness  is  often  the  most  trustworthy.  This  first  state¬ 
ment  can  be  made  less  reliable,  however,  by  a  careless  use  of  “  lead¬ 
ing  questions/'  which  are  a  danger  not  only  in  the  first  interview 
but  everywhere.  “ Every  one  of  us/'  says  Gross,  “has  made  the 
frightful  observation  that  by  the  end  of  an  examination  the  wit¬ 
ness  has  simply  taken  the  point  of  view  of  the  examiner,  and  the 
worst  thing  about  this  is  that  the  witness  still  thinks  that  he  is 
thinking  in  his  own  way."1 

A  witness  may  be  quite  sincere  also  in  thinking  that  he  knows 
more  about  an  event  or  a  person  than  he  really  does.  His  good 
faith,  therefore,  is  not  the  only  thing  to  establish.  His  compe¬ 
tence  includes  both  his  opportunity  to  know  the  facts  and  the  way 
in  which  he  has  used  his  opportunity.  This  latter  is  conditioned 
by  his  powers  of  attention,  memory,  and  suggestibility.  What 
ideas  had  he  in  stock,  moreover,  which  would  have  made  him  a 

1  Criminal  Psychology,  p.  163. 

346 


COMPARISON  AND  INTERPRETATION 


good  or  a  bad  observer?  What  reason  had  he  for  observing  care¬ 
fully? 

Apart  from  his  competence  as  a  witness,  what  risk  is  there  of 
bias  in  his  testimony?  Bias  may  be  racial,  national,  religious, 
political,  environmental,  or  some  element  of  self-interest  may 
enter  in.  Important  forms  of  environmental  bias  are  those  of  a 
man's  occupation  and  of  the  particular  habit  group  to  which  he 
belongs. 

Obviously  it  is  not  enough  to  add  statement  to  statement,  as  a 
phonograph  would.  The  processes  of  inference,  of  comparison  of 
material,  begin  with  the  first  interview  and  continue  through  all 
the  steps  leading  to  diagnosis. 

II.  THE  COMPARISON  OF  MATERIAL 
“  I  am  astonished,"  says  Dubois,  “  to  see  how  many  young  phy¬ 
sicians  possessing  all  the  working  machinery  of  diagnosis  do  not 
know  how  to  make  a  diagnosis.  It  is  because  the  art  of  diagnosis 
does  not  consist  merely  in  gathering  together  a  great  many  facts, 
but  in  co-ordinating  those  that  one  has  been  able  to  collect,  in 
order  to  reach  a  clear  conception  of  the  situation."1  And  we  are 
told  that  the  historian  first  collects  his  material,  then  collates  it, 
and  only  after  it  has  been  collated  attempts  his  final  interpretation. 
He  weighs  his  evidence,  of  course,  as  we  do,  item  by  item  when  it 
is  gathered,  but  a  reweighing  of  the  total  is  necessary  when  all 
the  items  are  in.  “After  a  student  has  learned  to  open  his  eyes 
and  see,"  writes  Dr.  Richard  Cabot  of  clinical  teaching,  “he  must 
learn  to  shut  them  and  think."2  So  must  we.  Nevertheless,  this 
stage  of  assembling  our  material,  of  relating  its  parts  and  trying 
to  bring  it  up  into  consciousness  as  a  whole,  will  not  be  easy  to 
illustrate,  since  it  is  the  most  neglected  part  of  case  work  technique. 
Speaking  broadly,  the  social  case  worker  of  an  earlier  day  did 
little  visiting  of  anyone  except  his  client  and  so  observed  only 
within  those  narrow  limits.  He  was  mentally  sluggish,  moreover, 
and  guilty  of  much  thoughtless  prescribing.  The  case  worker  of 
today  is  more  active  physically — sometimes  doing  too  much  run¬ 
ning  around,  one  is  tempted  to  believe — but  his  advance  in  useful- 

1  The  Psychic  Treatment  of  Nervous  Disorders,  p.  277. 

2  Case  Teaching  in  Medicine,  Introduction,  p.  vii. 

347 


1 


SOCIAL  DIAGNOSIS 


ness  over  earlier  workers  would  be  greater  if  he  would  oftener 
“shut  his  eyes  and  think,”  if  he  would  reduce  the  visible  signs  of 
his  activity  and  assemble  his  forces  in  order  the  better  to  deliberate 
upon  his  next  move  before  he  makes  it.  Case  records  often  show 
a  well  made  investigation  and  a  plan  formulated  and  carried  out, 
but  with  no  discoverable  connection  between  them.  Instead,  at 
the  right  moment,  of  shutting  his  eyes,  and  thinking,  the  worker 
seems  to  have  shut  his  eyes  and  jumped.  V On  the  other  hand,  how¬ 
ever  carefully  the  inquiries  are  recorded  and  the  diagnosis  which 
grew  out  of  them  indicated,  however  carefully  a  plan  of  action  is 
decided  upon,  etc.,  the  processes  by  which  the  diagnosis  is  arrived 
at — what  parts  of  the  evidence  have  been  accepted  or  rejected  and 
why,  what  inferences  have  been  drawn  from  these  accepted  items 
and  how  they  have  been  tested — can  none  of  them  be  revealed 
in  a  record. 

Some  case  workers  feel  that  their  conscious  assembling  of  ma¬ 
terial  comes  when  they  present  a  summary  to  the  case  committees 
of  volunteers  who  assist  them  in  making  the  diagnosis  and  the  plan 
of  treatment.  This  is  especially  true  if  any  of  the  members  of 
the  committee  have  a  social  experience  that  has  made  them  both 
critical  and  just  in  their  valuing  of  testimony.  One  worker 
writes,  “  Repeatedly,  flaws  in  my  investigation  have  not  occurred 
to  me  in  reading  over  the  record,  but  they  have  become  only  too 
evident  at  the  moment  of  presenting  the  case  to  my  committee. 
The  standard  in  my  mind  of  what  the  committee  ought  to  know  in 
order  to  make  a  fair  decision  has  then  suddenly  revealed  weaknesses 
to  me  before  they  were  brought  out  in  the  discussion.” 

The  same  bracing  influence  comes  from  submitting  findings  at 
this  stage  to  a  case  supervisor  who  is  responsible  for  the  work  of  a 
group  of  social  case  workers.  Indeed,  the  process  of  comparison, 
in  so  far  as  it  can  be  studied  at  all  at  present,  is  found  at  its  best 
in  the  daily  work  of  a  few  experienced  supervisors.  Unfortunately 
they  are  usually  persons  who  are  much  overburdened.  Although 
committees,  at  their  worst,  can  be  useless  as  critics,  when  well 
chosen  they  have  an  advantage  over  any  one  referee  in  that  they 
bring  not  only  less  jaded  minds  but  more  varied  experiences  to 
bear  upon  each  problem.  Either  supervisors  or  committees  have 
the  advantage  over  the  worker  who  makes  his  analysis  unaided, 

348 


COMPARISON  AND  INTERPRETATION 


that  they  do  not  know  the  client  or  his  story,  and  that  conse¬ 
quently  they  are  not  already  so  impressed  with  any  one  part  of  the 
story  as  to  be  unable  to  grasp  the  client’s  history  as  a  whole.1 

1.  Suggestions  for  Self-supervision.  In  the  absence  of  a  com¬ 
petent  supervisor  or  of  a  committee,  the  case  worker  will  often 
have  to  take  the  place  of  both  by  consciously  setting  aside  some 
time  in  which  he  will  strive  to  look  at  his  own  work  as  if  he  were  a 
critical  outsider.2 

(a)  He  can  try  to  review  each  item  of  a  case  with  all  »the  others 
in  mind.  When  each  particular  piece  of  evidence  came  to  him, 
he  judged  it  by  what  he  then  knew.  How  does  he  judge  it  now  in 
the  light  of  all  the  evidence? 

Gross  suggests  another  way  of  testing  our  material  which  is 
psychologically  more  difficult;  namely,  to  consider  a  part  of  it 
with  other  material  deliberately  excluded.3 

This  is  what  a  probation  officer  had  to  do,  probably,  when  a  father  lodged  com¬ 
plaint  against  his  boy  for  stubbornness  and  for  thieving  from  his  older  brothers. 
The  home  seemed  so  satisfactory  that  she  was  inclined  to  seek  the  cause  of  the 
trouble  in  outside  influences  that  would  have  led  the  lad  to  take  first  small  sums  and 
then  much  larger  ones.  When,  however,  the  time  came  for  planning,  the  explana- 

1  A  case  reader  of  wide  experience  suggests  here  that,  in  fields  of  work  where  no 
committee  is  possible  and  no  supervisor  is  at  hand,  someone  with  a  keen  mind  be 
introduced  to  case  record  reading  and  that  current  problems  be  “tried  out  on  him.” 
Even  where  there  is  a  committee  it  is  important  that  someone  on  the  committee 
besides  the  case  worker  read  the  record  before  the  case  comes  up  for  discussion. 

2  Any  detailed  discussion  of  the  worker’s  case  records  must  be  reserved  for  a 
separate  book  on  that  subject,  though  self-supervision  might  well  include  not  only 
the  case  work  but  its  recording.  Charles  Kingsley  warned  a  young  writer  that  he 
should  never  refer  to  anything  as  a  “tree”  if  he  could  call  it  a  “spruce”  or  a  “pine.” 
If  that  lesson  had  been  impressed  upon  the  present  generation  of  case  recorders, 
the  task  of  writing  this  book  would  have  been  an  easier  one. 

Among  the  general  terms  against  which  collectors  of  family  histories  for  eugenic 
study  are  warned  by  the  Cold  Spring  Harbor  Eugenics  Record  Office  (see  Eugenics 
Record  Office  Bulletin  No.  7,  p.  91)  are  abscess,  without  cause  or  location;  acci¬ 
dent,  decline,  without  naming  the  disease;  cancer,  without  specifying  organ  first 
affected;  congestion,  without  naming  organ  affected;  convulsions,  without  details 
and  period  of  life;  fever;  heart  trouble  and  heart  failure;  insanity,  without  details; 
kidney  trouble;  lung  trouble;  marasmus;  stomach  trouble. 

The  social  case  worker’s  Index  Expurgatorius  would  have  to  cover  a  much  wider 
range  of  subjects;  but  some  of  the  commonest  substitutions  are  relative  for  the  word 
expressing  the  exact  degree  of  relationship;  Italian  or  Austrian  or  German  for  the 
term  descriptive  of  a  native  of  the  particular  province  or  other  political  subdivi¬ 
sion;  day  laborer  or  salesman  or  clerk  for  the  particular  occupation;  and  bad,  dull, 
unsanitary,  shiftless,  incompetent,  unsatisfactory,  good,  bright,  industrious,  proud, 
refined,  and  a  host  of  such  adjectives  for  the  specific  act  or  condition. 

3  Criminal  Psychology,  p.  12. 


349 


SOCIAL  DIAGNOSIS 


tion  had  not  been  found,  and,  having  a  mind  that  demanded  specific  data  instead 
of  falling  back  upon  an  unsupported  theory,  she  began  her  search  anew  and  ex¬ 
cluding  from  her  mind  for  the  time  being  the  favorable  family  appearances,  found 
two  court  records  of  the  arrest  of  the  father,  one  for  buying  junk  from  minors  and 
the  other  for  peddling  without  a  license.  These  may  seem  small  offenses,  but  they 
were  serious  enough  in  the  father  of  a  boy  who  was  also  developing  a  tendency  to 
lawlessness. 

(b)  Sometimes,  as  Gross  suggests  also,  the  grounding  of  a  fact 
has  been  so  difficult,  has  taken  so  much  time,  that  we  slur  over  the 
task  of  establishing  its  logical  connection  with  the  whole,  or  do  that 
part  of  our  work  “swiftly — and  wrongly.”1  Or  sometimes  the 
slurring  is  due  to  the  desire  to  make  a  definite  report  with  prompt¬ 
ness,  as  in  the  following  case: 

A  charity  organization  society  was  asked  in  August  by  the  state’s  attorney  to 
interest  itself  in  a  non-support  case,  in  which  the  man  of  the  family  had  been  ar¬ 
rested  for  not  making  weekly  payments  to  his  wife  on  the  separate  support  order  of 
the  court.  A  week  later  the  society  submitted  a  report  of  its  inquiry  upholding  the 
wife.  In  October,  however,  when  the  man  made  application  to  have  his  children 
removed  from  the  home,  an  exhaustive  study  of  the  case  revealed  bad  conditions 
there.  A  critic  of  this  case  record  writes:  “Before  your  first  report  to  the  state’s 
attorney  was  sent,  contradictions  in  the  evidence  had  developed  that  should  have 
made  it  clear  to  you  that  further  investigation  was  needed.  The  sources  of  informa- . 
tion  were  at  hand  and  the  winter’s  rush  was  not  upon  you.” 

(c)  As  was  the  case  in  the  foregoing  example,  a  review  of  our 
material  will  often  reveal  unsuspected  contradictions  in  the  evi¬ 
dence.  Where  these  contradictions  cannot  be  reconciled  we  may 
safely  infer  that  further  evidence  is  needed;  where,  though  all  the 
evidence  points  one  way,  no  explanation  of  the  difficulty  or  guide 
to  its  solution  has  been  revealed,  we  must  again  look  for  additional 
facts. 

(d)  The  rhetorics  tell  us  that  the  first  and  last  paragraphs  of  an 
essay  are  the  two  that  make  the  deepest  impression  upon’the  reader. 
It  may  be  well  to  ask  always,*  therefore,  whether  the  story  as  told 
by  the  first  person  seen,  or  the  first  theory  adopted  by  the  worker 
has  received  undue  consideration  in  shaping  the  final  conclusion; 
or  whether  the  last  statement  made  has  been  allowed  this  advan¬ 
tage.  Anyone  who  has  had  occasion  to  note  the  eagerness  of  each 
of  two  complainants  to  tell  his  grievance  first  will  appreciate  that 

1  Criminal  Psychology,  p.  143. 

350 

'  ’  ..  /’ 


COMPARISON  AND  INTERPRETATION 


we  have  an  intuition  that  first  impressions  are  lasting.  Where 
there  have  been  matters  in  dispute,  however,  the  strategic  posi¬ 
tion — second  only  in  value  to  the  first — is  the  last.  In  short,  we 
must  guard  against  the  impression  made  by  first  and  by  last  state¬ 
ments  in  an  investigation. 

In  all  this  analysis  of  data  the  suggestions  made  in  Part  I  in  the 
discussion  of  inferences  will  be  found  useful.1  What  is  there  said 
about  the  testing  of  inferences  applies  to  their  retesting  by  the 
case  worker,  and  is  so  fundamental  that  it  has  seemed  best  not  to 
restate  in  abbreviated  form  the  conclusions  of  that  chapter  at  the 
beginning  of  this.  There  are,  however,  many  of  the  details  in  the 
later  process  of  comparison — in  the  process  of  examining  critically, 
that  is,  the  gathered  testimony — which  are  best  summarized  on  the 
assumption  that  someone  besides  the  case  worker  himself  is  to  re¬ 
view  a  mass  of  evidence. 

2.  Suggestions  for  Comparisons  Made  by  a  Supervisor.  What 
should  a  supervisor  look  for  in  a  case  record  in  which  the  work  has 
reached  the  stage  of  evidence  gathered  but  not  yet  compared  or 
interpreted?  For  convenience  of  reference  the  treatment  of  this 
topic  has  been  reduced  to  questionnaire  form  and  added  to  the 
series  of  questionnaires  in  Part  III,2  but  every  other  questionnaire 
in  this  volume  should  be  understood  to  have  a  relation  to  super¬ 
visory  work  and  to  the  comparisons  made  in  self-supervision. 
The  questionnaire  for  supervisors  summarizes  material  scattered 
throughout  this  volume  and  rearranges  it  under  the  heads  of  (a) 
the  case  worker’s  relations  with  client,  (b)  with  client’s  family, 
(c)  with  outside  sources,  (d)  the  conduct  of  the  inquiry  as  a  whole, 
and  (e)  wider  aspects  of  the  inquiry. 

Good  supervision  must  include  this  consideration  of  wider  as¬ 
pects.  We  have  seen  that  the  habit  of  keeping  in  mind  the  bearing 
of  each  individual  fact  on  general  social  conditions  gives  added  sig¬ 
nificance  to  the  statements  in  a  record.  This  habit  may  also  open 
broader  avenues  of  usefulness.  Every  case  worker  has  noticed  how 
a  certain  juxtaposition  of  facts  often  reappears  in  record  after 
record,  and  must  have  suspected  that  this  recurring  juxtaposition 
indicates  a  hidden  relation  of  cause  and  effect.  Or  else  he  must 
have  noted  that  some  twist  in  the  affairs  of  clients  showed  again 
1  See  p.  8 1  sq.  2  See  p.  449  sq. 


351 


SOCIAL  DIAGNOSIS 


and  again  a  marked  similarity  of  outline  such  as  to  suggest  a  com¬ 
mon  cause,  though  no  rational  explanation  came  to  hand.  It  is 
here  that  the  “notation  of  recurrence,”  as  it  is  called,  becomes  a 
duty  of  supervisor  and  case  worker.  Not  only  should  these  repe¬ 
titions  be  noted  but  they  should  be  compared  carefully.  Some 
situations  that  seemed  similar  will  be  found  upon  examination  to 
be  different  in  essence,  but  the  remainder,  if  they  are  likely  to 
throw  light  on  social  conditions  or  on  the  characteristics  of  any 
disadvantaged  group,  should  be  submitted  to  those  specialists  in 
social  reform  who  can  make  a  critical  and  constructive  use  of  them. 
The  getting  at  knowledge  that  will  make  the  case  work  of  another 
generation  more  effective  may  be  only  a  by-product  of  our  own  case 
work,  but  it  is  an  important  by-product.1  The  wider  significance 
of  case  work  data  is  illustrated  incidentally  in  the  analysis  of  the 
Ames  case,  which  follows: 

3.  The  Ames  Case.  On  page  84  will  be  found  the  face  card  of 
a  family  record  of  the  Ameses,  begun  in  1909,  together  with  a  dis¬ 
cussion  of  some  of  the  inferences  drawn  from  it  by  a  case  worker 
who  had  not  read  the  record  itself.  This  process  of  drawing  in¬ 
ferences  from  a  face  card  and  then  testing  them  by  the  record  or  by 
further  inquiry  will  be  found  useful  in  review  procedure. 

Let  us  now  see,  without  attempting  to  reproduce  the  Ames 
record,2  how  a  few  of  the  suggestions  in  this  section  may  be  ap¬ 
plied  to  the  story  of  that  family: 

1  Dr.  Adolf  Meyer,  addressing  a  group  of  after-care  committees  for  the  insane, 

just  after  having  read  some  of  their  records,  says,  “I  had  to  put  a  big  black  cross 
in  my  mind  over  the  town  of  Waterloo.  There  is  a  town  which  evidently  contains 
centers  of  infection,  which  the  community  cannot  afford  to  tolerate,  and  which 
can  be  attacked  if  one  has  sufficient  material  against  them.  .  .  .  The  authori¬ 

ties  and  the  good  and  bad  people  may  not  pay  much  attention  to  remonstrations 
until  sufficient  material  accumulates  and  is  plunged  at  the  right  time,  and  then  you 
may  be  able  to  do  something.  These  are  difficult  tasks,  I  know,  but  there  is  no 
way  of  doing  anything  by  keeping  quiet  or  by  making  abstract  complaints." — 
After-care  and  Prophylaxis,  p.  16.  Reprint  of  an  article  in  the  State  Hospitals 
Bulletin,  March,  1909,  authorized  by  the  State  Commission  in  Lunacy,  Albany, 
N.  Y.  Utica,  N.  Y.,  State  Hospitals  Press,  1909. 

2  Study  of  the  original  case  record  would  be  more  satisfactory,  for  case  workers 
will  always  disagree  as  to  what  is  important  and  what  is  not  in  the  making  of  a 
summary.  On  the  other  hand,  a  social  case  record  which  is  fully  adequate  for  study 
is  such  an  identifiable  thing  that  the  writer  has  never  been  willing  to  publish  one. 
The  few  that  have  been  privately  printed  for  class  study  only  have  been  excellent 
teaching  material,  though  even  in  the  use  of  these  few  the  danger  of  violating  the 
confidences  of  clients  has  not  been  completely  avoided,  and  the  problem  of  recon¬ 
ciling  their  use  with  the  highest  case  work  ethics  has  been  a  puzzling  one. 

352 


COMPARISON  AND  INTERPRETATION 


Thomas  Ames  is  a  tuberculous  hatter  of  thirty-eight  with  a  wife  of  twenty-eight 
and  two  children,  girls  aged  six  and  nearly  two.  Mrs.  Ames’  mother  lives  with 
them.  The  family  had  been  reported  as  in  distress  to  a  charitable  woman,  Miss 
Delancey,  when  she  happened  to  be  visiting  some  of  their  neighbors.  After  one 
visit  to  the  Ameses,  she  sought,  on  May  io,  the  advice  and  aid  of  the  nearest  dis¬ 
trict  office  of  the  charity  organization  society.  One  of  the  society’s  case  workers 
held  the  first  interview  in  the  home  that  same  day,  noting  on  the  record  that  she 
was  obliged  to  interview  Ames,  his  wife,  and  his  mother-in-law  together. 

Mr.  Ames  gave  at  this  time  his  story  of  work  at  Caldwell’s  hat  factory  ever  since 
his  marriage,  and  stated  that  the  tuberculosis  dispensary  had  advised  him  to  apply 
for  admission  to  the  state  sanatorium,  but  that  he  could  not  leave  his  family.  He 
was  seeking  work  as  an  insurance  solicitor,  hoping  in  this  way  to  become  stronger. 
The  mother-in-law  was  not  working  for  reasons  unstated.  The  church  had  helped 
but  was  too  poor  to  continue,  or  so  the  family  believed.  Mrs.  Ames  had  never  been 
strong  since  the  younger  child's  birth.  She  showed  some  hesitation  about  having 
any  of  her  own  or  her  husband’s  people  seen.  Mr.  Ames,  however,  said  that  he 
understood  the  case  worker’s  desire  to  consult  them  and  furnished  the  addresses 
of  his  four  brothers  and  sisters  and  of  his  wife’s  two  sisters. 

The  outside  visits  were  then  made  in  the  following  order:  Tuberculosis  dis¬ 
pensary,  Mrs.  Ames’  two  sisters,  her  doctor,  the  school  principal  of  the  older  child, 
one  of  Mr.  Ames’  brothers,  and  his  two  sisters,  then  the  tuberculosis  dispensary 
twice  again,  followed  by  an  interview  with  Mrs.  Ames  alone.  Only  after  all  these 
visits  had  been  made  were  the  manager  of  the  hat  factory  and  the  pastor  of  the 
church  seen. 

What  did  these  outside  visits  reveal?  An  unusually  simple  family  history,  which 
for  that  reason  is  used  here  for  illustration.  The  dispensary  doctor  was  not  found 
until  the  third  visit  to  the  dispensary,  which,  aside  from  sending  a  quart  of  milk 
daily,  had  had  no  contact  with  the  home.  The  medical  record  showed  that  Ames’ 
condition  was  grave,  that  he  was  running  a  high  temperature  and  was  unable  to 
work. 

Mrs.  Ames’  two  sisters  spoke  in  high  terms  of  Ames’  industry  and  kindness  to 
his  family.  The  older  child  was  reported  by  the  school  principal  to  be  quiet,  well 
trained,  and  diligent,  i?ut  “by  no  means  bright.”  Mrs.  Ames’  doctor  had  known 
the  family  a  long  while,  spoke  well  of  them,  but  was  vague  about  the  wife’s  health, 

describing  her  as  “always  frail,”  and  did  not  state  how  long  it  had  been  since  he 

\ 

had  last  treated  her. 

Joseph  Ames  and  his  wife  had  not  realized  before  the  seriousness  of  the  situation. 
On  learning  it,  they  offered  Mrs.  Ames  and  her  children  a  home  if  her  husband  would 
go  to  the  sanatorium.  (The  case  worker  said  on  the  spot  that  she  thought  the  plan 
an  excellent  one,  though  the  interview  developed  that  both  Joseph  and  his  wife  were 
sure  Mrs.  Ames  should  go  to  work  and  that  she  was  “too  high-toned.”)  Their  sister, 
Clara,  seen  on  May  i 5,  was  found  to  know  the  Ameses  better  than  the  other  relatives 
of  the  husband.  She  dropped  a  hint  that  Ames  was  willing  to  go  away,  but  that 
his  wife  was  holding  him  back  and  urging  him  to  find  other  work. 

The  case  worker  had  had  no  intimation  of  this,  but  it  proved  the  key  to  all  the 


23 


353 


SOCIAL  DIAGNOSIS 


treatment  that  followed.  A  private  interview  was  had  with  Mrs.  Ames.  She 
could  not  believe  at  first  that  her  husband’s  condition  was  as  grave  as  represented, 
and  moreover  was  worried  as  to  what  was  to  become  of  her  home  and  her  children. 
It  was  possible  to  convince  her  that  Ames  was  a  very  sick  man,  and  to  reassure  her 
as  to  her  household.  The  explanation  of  Ames’  attitude  having  been  passed  on  to 
the  dispensary,  the  doctor  there  was  able  to  persuade  his  patient  to  apply  for  ad¬ 
mission  to  the  sanatorium. 

It  had  taken  ten  days  to  accomplish  this.  Thereafter  followed  quickly  visits 
to  the  two  important  sources  of  co-operation  in  the  case — the  employer  and  the 
church.  Although  Caldwell’s  had  aided,  the  firm  did  not  know  that  Ames  had 
tuberculosis  or  was  incapacitated  for  any  work.  They  agreed,  in  the  light  of  this 
development,  to  pay  $5.00  a  week  until  Ames  could  be  admitted  to  the  sanatorium. 
(The  period  of  help  was  extended  later  to  the  date  of  Ames’  return.)  The  pastor 
of  the  church  agreed  to  supply  whatever  food  was  needed. 

During  an  interval  of  some  months  before  Ames  could  be  admitted,  Miss  De- 
lancey  served  as  a  regular  visitor  to  the  family,  with  the  immediate  object  of  sug¬ 
gesting  the  necessary  precautions  for  the  invalid.  With  a  sleeping  tent  in  the  back 
yard,  Ames  actually  made  some  slight  gains  at  home  before  his  five  months  away. 

This  social  diagnosis  and  treatment,  which  was  successful  in  the  promptness  with 
which  it  got  at  the  heart  of  the  difficulty — a  personal  as  well  as  an  economic  one — 
and  rallied  the  outside  sources  to  meet  it,  had  some  weaknesses  which  a  competent 
supervisor  would  quickly  discover.  Ames  came  back  well  enough  to  take  and  keep 
more  healthful  work  under  his  old  employers.  But  just  after  he  went  to  the  sana¬ 
torium  in  September,  Mrs.  Ames  developed  an  incipient  case  of  tuberculosis. 
Fortunately  the  infection  was  discovered  in  time;  but  the  fact  is  there  had  been 
such  concentration  upon  the  problem  of  the  sick  man  that  preventive  examinations 
of  wife  and  children — a  precaution  more  often  neglected  in  1909  than  now,  it  is 
true — had  not  been  made.  And  why  was  a  woman  described  as  frail  left  with  no 
more  definite  diagnosis  for  four  months?  The  opinions  of  the  relatives  on  both 
sides  of  the  house  as  to  her  health,  her  ability  tp  work,  etc.,  were  set  down  in  the 
record,  but  no  competent  professional  judgment  was  procured. 

Then,  before  the  inquiry  had  been  completed,  the  offer  from  the  Joseph  Ameses 
of  a  home  with  them  for  Mrs.  Ames  and  the  children  had  been  accepted  by  the  case 
worker  as  a  definite  solution  without  weighing  the  arguments  for  and  against. 
Probably  it  was  so  received  because  it  was  the  first  concrete  offer  made.  Its 
abandonment  later  may  have  been  because  other  resources  became  available,  and 
may  have  had  no  reference  to  the  real  objections  to  this  solution  on  the  score  of 
health,  incompatibility,  the  difficulty  of  re-establishing  the  home  once  it  had  been 
broken  up,  etc. 

What  does  the  school  principal  mean  by  her  statement  that  Alice  Ames  is  "a 
diligent  student,  although  by  no  means  a  bright  child”? 

Even  in  so  relatively  simple  a  case  as  this  one,  a  comparison  of 
all  the  items  of  evidence,  both  by  the  case  worker  and  by  someone 
who  did  not  know  the  Ameses,  would  have  saved  motion  in  useless 

354 


COMPARISON  AND  INTERPRETATION 


directions  and  have  started  it  in  helpful  ones.  A  supervisor 
skilled  in  the  notation  of  recurrence,  moreover,  would  have  learned 
from  the  study  of  other  cases  that  not  only  in  the  hat  factory  where 
Ames  worked  but  in  certain  branches  of  the  whole  industry  did 
an  unduly  large  proportion  of  tuberculosis  cases  have  their  origin. 
This  feature  of  the  case  noted,  all  available  data  should  have  been 
placed  at  the  service  of  students  of  occupational  disease  in  its 
legislative  and  other  aspects.  Not  satisfied  with  search  in  this 
one  direction,  the  supervisor  should  have  sought  for  possible 
causal  factors  of  Ames’  disease  in  his  family  history  and  his  home 
sanitation. 

At  the  same  time  it  must  be  admitted  that  both  case  worker  and 
supervisor  might  have  made  all  these  comparisons  painstakingly, 
might  have  secured  the  necessary  medical  diagnoses  of  mother  and 
children,  and  the  mental  examination  of  the  older  child,  might  have 
organized  a  committee  to  investigate  the  relation  between  hat 
making  and  tuberculosis,  and  might  still  have  failed  utterly  in  the 
social  diagnosis  and  treatment  of  the  Ameses.  “They  go  through 
all  their  paces,”  said  a  social  worker  of  certain  trained  assistants, 
“they  attend  to  all  the  latest  things  listed  in  our  modern  social 
programs,  and  then  miss,  far  too  often,  the  most  significant  point 
in  the  whole  case.”  This  is  another  way  of  saying  what  Dubois 
has  said — they  possess  all  the  working  machinery  of  diagnosis 
but  do  not  know  how  to  make  a  diagnosis.1  Painstaking  com¬ 
parison  of  all  the  items  of  evidence  aids  and  leads  up  to  interpre¬ 
tation,  it  often  reveals  the  interpretation,  but  it  cannot  provide 
the  imaginative  insight  which  can  make  interpretation  more  than 
half  of  treatment. 

III.  THE  INTERPRETATION  OF  MATERIAL 

Ability  to  form  a  judgment  is  more  important  than  ability  to 
suspend  judgment.  We  are  between  the  horns  of  a  dilemma  here, 
for  the  diagnosis  too  promptly  made,  even  when  not  erroneous,  may 
be  only  the  one-word  diagnosis  which  roughly  describes  the  general 
type  of  difficulty,  and  leaves  undefined  every  individualizing  par¬ 
ticular.  The  delayed  diagnosis,  on  the  other  hand,  may  miss 
the  critical  moment  for  effectiveness  in  treatment.  With  all  the 

1  See  p.  347. 

355 


SOCIAL  DIAGNOSIS 


defects  apparent  in  the  social  handling  of  the  Ames  case,  it  shows 
ability  to  grasp  promptly  the  significant  factor  in  a  human  rela¬ 
tion — in  this  instance,  the  wife’s  unwillingness  to  have  her  husband 
leave  home,  and  the  reason  for  it.  It  is  this  insight  into  human 
relations  that  distinguishes  social  diagnosis  from  all  other  kinds. 

The  dispensary  had  known  Ames  for  a  number  of  weeks  and  had 
diagnosed  only  the  disease,  his  church  and  his  employer  had  known 
him  for  years  and  had  observed  only  the  distress,  when  a  social 
case  worker,  called  in  more  or  less  by  chance,  found  the  true  situa¬ 
tion,  simple  as  it  was,  still  undefined  and  unanalyzed.  Some  fum¬ 
bling  followed.  The  social  diagnosis  might  have  been  swamped 
by  the  premature  remedy  proposed  by  the  Joseph  Ameses.  The 
check,  however,  was  momentary,  and  five  days  after  the  original 
application  the  key  to  the  situation  had  been  found.  The  highest 
success,  of  course,  would  have  been  to  find  and  hold  to  this  main 
theme  without  losing  grasp  upon  the  other  and  related  matters 
that  were  already  in  evidence.  Miss  Delancey  was  at  hand  and 
eager  for  direction.  Assuming  the  possibility  of  her  success  in 
aiding  the  family  to  rearrange  home  conditions  for  the  invalid 
father,  this  could  have  been  counted  upon  to  make  her  all  the  more 
influential  in  looking  after  the  physical  and  mental  health  of  the  j 
two  little  girls  and  the  health  of  their  mother.  That  these  were  not 
included  in  the  program  from  the  very  beginning  was  a  waste  of 
time  and  opportunity. 

Sometimes  where  there  has  been  frequent  change  of  social  agency 
or  of  worker  in  a  case,  every  type  of  diagnostic  habit  will  be  found 
in  a  single  record — the  one-word  diagnosis,  the  situation-of-the- 
moment  diagnosis,  the  painstaking  but  fumbling  kind,  the  clear- 
on-the-main-difficulty  type,  as  well  as  the  type  which  is  both  clear 
and  full.  ^ 

Take,  for  example,  the  family  of  Braucher,  the  man  with  a  South 
American  wife  and  two  small  children,  whose  story  is  told  in  part 
in  the  chapter  on  Relatives.1  The  family,  it  will  be  remembered, 
had  been  treated  in  four  different  districts  of  one  charity  organiza¬ 
tion  society.  First,  the  situation  was  summarized  as  “man  unable 
to  work  because  of  flat-foot;  distress  of  family  due  to  this  cause.” 
Later,  when  Braucher  had  neglected  the  medical  treatment  offered, 

1  See  p.  1 88. 

356 


COMPARISON  AND  INTERPRETATION 


and  when  routine  efforts  to  verify  his  story  had  failed,  it  was 
summed  up  in  the  phrase,  “family  shows  industry  as  beggars,  but 
in  no  other  way/’  A  local  charity  in  another  city  had  offered,  as  a 
definition  of  the  characteristics  of  the  man’s  relatives,  who  lived 
there,  the  statement  that  they  were  people  with  “a  discouraging 
record.”  But  the  secretary  in  the  fourth  district,  dissatisfied  with 
this  report,  had  sought  out  Rraucher’s  people  and  brought  back 
to  him  a  message  from  them.  The  message  appealed  to  an  unsus¬ 
pected  side  of  the  man’s  nature — a  fact  which  this  fourth  social 
diagnostician,  unprejudiced  by  earlier  verdicts,  was  prompt  to  recog¬ 
nize.  The  renewal  of  Braucher’s  relations  with  long  estranged 
kindred  became  the  worker’s  starting  point  in  the  attempt  to 
develop  his  social  and  industrial  ambitions,  these  ambitions  be¬ 
coming  in  turn  the  keynote  in  a  long  and  successful  treatment. 
With  all  this,  Mrs.  Braucher’s  separate  needs  were  not  overlooked. 
Social  diagnosis  should  not  limit  itself  to  the  naming  of  one  cause  or 
one  disability. 

It  would  be  possible  to  maintain,  of  course,  that  the  worker  who 
succeeded  where  three  had  failed  had  a  stronger  faith  in  human 
nature  or  a  more  winning  personality.  Unquestionably  these 
were  factors  in  the  success.  As  has  been  said  elsewhere,  faith  in 
the  possibilities  of  our  clients  and  of  social  treatment  is  funda¬ 
mental.  But  the  turning  point  was  the  discovery  of  the  relatives 
by  one  who  knew  how  to  weigh  evidence  and  to  follow  slight  clues. 
Success  was  due  to  technique  and  insight  in  combination. 

1.  Diagnosis  Redefined.  Social  diagnosis,  then,  may  be  described 
as  the  attempt  to  make  as  exact  a  definition  as  possible  of  the  situa¬ 
tion  and  personality  of  a  human  being  in  some  social  need — of  his 
situation  and  personality,  that  is,  in  relation  to  the  other  human 
beings  upon  whon^  he  in  any  way  depends  or  who  depend  upon 
him,  and  in  relation  also  to  the  social  institutions  of  his  community. 

Medical  diagnosis  leans  more  and  more  to  the  inclusion  of  a 
certain  amount  of  social  context;  diagnoses  of  mental  states  will 
in  time  do  the  same.  Each,  however,  will  continue  to  be  based 
upon  a  body  of  experience  which  is  not  primarily  social,  which  has 
a  different  starting  point  and  develops  a  different  skill  and  em¬ 
phasis.  The  fields  overlap  but  are  by  no  means  coterminous. 
As  social  diagnosis  becomes  more  expert  it  will  be,  incidentally, 

357 


SOCIAL  DIAGNOSIS 


a  serviceable  adjunct  of  medicine  and  of  psychology,  and  there  is 
no  need  to  add  that  both  of  these  will  continue  to  furnish  invalu¬ 
able  data  to  the  social  diagnostician. 

Since  this  book  is  not  addressed  to  the  specialist  in  any  one 
branch  of  social  case  work,  it  cannot  narrow  its  field  to  suggestions 
which  would  not  apply  to  all  branches.  With  this  limitation,  it 
will  not  be  possible  to  dogmatize  about  the  content  of  a  diagnosis, 
about  the  making  of  diagnostic  summaries,  or  even  about  the  time 
element  in  this  part  of  case  work;  it  will  only  be  possible,  in  bring¬ 
ing  the  discussion  of  this  final  stage  to  a  close,  to  add  under  these 
various  heads  a  few  general  suggestions. 

2.  Diagnostic  Content.  A  poor  social  diagnosis  errs  by  being 
too  general,  by  being  too  detailed  and  therefore  confused,  or  by 
overlooking  some  of  the  important  factors  in  a  case  though  clear 
on  the  main  disability;  whereas  good  social  diagnosis  includes  all 
the  principal  factors  standing  in  the  way  of  social  reconstruc¬ 
tion,  with  emphasis  placed  upon  the  features  which  indicate  the 
treatment  to  be  followed.  This  emphasis  the  worker  should  allow 
no  predisposition  toward  some  favorite  causal  factor  to  disturb. 

A  diagnosis  may  be  mistaken.  It  is  humiliating  to  find  that  a 
case  of  mental  disease  or  of  tuberculosis  can  still  be  diagnosed  by 
a  social  agency  as  a  case  of  unemployment  due  to  laziness  or  in¬ 
efficiency.  On  the  other  hand,  it  is  exasperating  to  find  that  a 
tuberculosis  nurse  can  still  tell  a  patient,  upon  her  first  visit,  that 
his  is  the  worst  case  of  overwork  she  has  ever  encountered,  when 
the  facts  are  notorious  that  he  has  never  supported  himself  and 
his  family,  and  that  he  has  undermined  his  health  by  years  of 
dissipation.  This  absorption  of  the  worker  in  the  superficial 
aspects  of  a  case  is  responsible  for  many  mistaken  diagnoses. 

A  diagnosis  may  be  a  mere  classification.  It  may  be  no  better 
than  pigeon-holing.  The  one-word  diagnosis,  even  when  it  names 
the  general  type  of  difficulty ‘with  correctness,  is  not  social.  In 
the  days  of  disorganized  social  dosing,  a  woman  with  children  and 
no  male  head  in  her  household  might  be  recorded  by  different 
agencies  as  a  widow,  a  deserted  wife,  or  an  unmarried  mother  with¬ 
out  any  of  them  having  verified  her  civil  condition.  Although 
the  affixing  of  the  correct  label  is  an  advance,  no  such  label  stand¬ 
ing  by  itself  has  a  practical  bearing  upon  prognosis  and  treatment. 

358 


COMPARISON  AND  INTERPRETATION 


Widowhood,  desertion,  illegitimacy — these  are  only  isolated  social 
facts  having  no  diagnostic  significance  until  their  context  in  the 
particular  instance  is  given.  How  varied  that  context  may  be  is 
partially  indicated  by  the  questionnaires  bearing  upon  these  three 
disabilities  in  Part  III. 

A  diagnosis  may  be  too  detailed.  As  the  purpose  of  diagnosis  is  to 
throw  into  high  light  the  factors  most  influential  in  bringing  a  client 
to  his  present  pass,  it  follows  that  the  including  of  details  is  apt 
to  spoil  the  perspective  and  so  give  either  a  distorted  or  a  confused 
picture  of  the  situation.  In  other  words,  the  defining  of  a  client's 
need  calls  upon  the  worker  to  distinguish  in  the  evidence  collected 
what  is  relatively  important  for  successful  treatment  from  what 
is  relatively  unimportant.  A  worker  may  have  gathered  the  evi¬ 
dence  in  a  case  with  care;  he  may  have  had  his  perceptions  awak¬ 
ened  in  many  directions  by  the  ablest  books  on  the  causes  of 
poverty;  yet  he  may  have  failed  to  recognize  the  factors  working 
most  mischief  in  the  case  under  consideration.  In  short,  his  work 
may  be  painstaking  but  without  penetration.  The  remedy  lies 
in  experience  under  skilful  supervision,  where  this  is  possible, 
as  well  as  in  a  deepened  sense  of  fellowship  with  one’s  clients. 

A  diagnosis  may  be  partial,  although  clear  on  the  main  difficulty. 
This  was  true  in  the  Ames  case;  it  is  true  today  of  much  of  the  work 
of  case  workers  with  method  and  experience  above  the  average. 
The  saving  strength  in  their  work  is  that  they  are  testing  diagnosis 
continually  by  that  knowledge  of  the  consequences  of  a  given 
treatment  as  applied  to  a  given  diagnosis  which  comes  only  from 
long  familiarity  with  social  practice.  The  weakness  in  their  work 
is  that  they  are  apt  to  note  and  to  treat  merely  some  one  con¬ 
spicuous  need  in  a  number  of  cases  too  large  to  allow  of  more 
thorough  work.  True  as  it  is  that  the  results  of  treatment  must 
be  the  usual  test  of  a  diagnosis,  practical  experience  in  observing 
these  results  will  not  save  a  worker  who  is  under  the  pressure  of 
too  many  cases  from  getting  but  a  partial  view  of  their  complexi¬ 
ties  and  possibilities. 

A  diagnosis  can  be  full  without  loss  of  clearness.  It  is  wasteful 
to  gather  ample  evidence  and  then,  in  our  eagerness  for  quick 
results  in  dealing  with  some  urgent  need,  lose  sight  of  the  facts 
significant  for  a  more  searching  treatment.  A  fuller  diagnosis 

359 


SOCIAL  DIAGNOSIS 


would  bring  these  into  the  picture  of  the  case  without  obscuring 
any  immediate  issue. 

Thus  far,  emphasis  has  been  placed  upon  the  defining  of  the 
difficulty  in  the  client's  situation.  We  must,  however,  remember 
that,  while  making  a  comprehensive  diagnosis  which  is  to  be  fol¬ 
lowed  by  treatment,  we  must  keep  the  clues  to  possible  remedies 
in  view.  The  diagnosis  itself  should  bring  together  those  elements 
in  the  situation  which  may  become  obstacles  or  aids  in  the  treat¬ 
ment.  We  have  no  word  for  this  summing  up  of  assets  and  lia¬ 
bilities.  Its  inclusion  in  diagnosis  is  justified  only  on  the  ground 
that  the  diagnostician,  who  must  have  had  social  treatment  in 
view  from  the  very  beginning,  has  been  measuring  at  every  stage 
of  his  work  the  treatment  value  of  each  circumstance,  each  human 
relation,  and  each  personal  characteristic.  Here  then  is  the  place 
to  sum  them  up. 

)The  diagnostic  summary,  or  the  diagnosis  put  in  black  and  white, 
should  give  the  content  of  a  diagnosis  in  orderly  form,  although 
that  form  may  have  to  be  somewhat  varied  for  different  types  of 
social  case  work.  Most  types  will  have  to  include,  in  addition  to  a 
general  description  of  the  difficulty,  a  statement  of  those  peculi¬ 
arities  of  circumstance  and  personality  which  differentiate  the 
case  under  review  from  all  others.  Then  should  come  an  enumera¬ 
tion  of  the  causal  factors,  so  far  as  known,  in  the  order  of  their 
importance.  It  is  a  help  to  clearness  of  thinking  to  set  them  down, 
though  they  must  be  understood,  at  this  early  stage  of  treatment, 
to  be  only  tentative.1  And  last  should  come  the  just  mentioned 
appraisal  of  the  assets  for  reconstruction  discovered  in  the  course  of 
inquiry — those  within  our  client,  within  his  immediate  family, 
and  outside.  The  inquiry  has  had  this  for  one  of  its  chief  objects. 
Not  only  the  assets  but  the  special  obstacles  to  be  overcome  and 
guarded  against  in  treatment  should  be  included.  All  of  this  must 
be  dated  and  must  stand,  like  a  bill  of  lading,  “errors  and  omis¬ 
sions  excepted."  There  would  be  few  more  dangerous  things 


1  This  listing  of  factors  recognized  as  causal  in  the  individual  case  should  not  be 
confused  with  the  attempt  to  establish  statistically  the  causes  of  poverty,  crime,  or 
any  other  of  society’s  outstanding  failures.  To  any  such  generalizing  other  tests 
must  be  applied.  The  two  undertakings  may  be  related  or  may  become  so  some 
day,  but  they  cannot  be  assumed  to  be  identical. 

360 


COMPARISON  AND  INTERPRETATION 


than  a  social  diagnosis  that  was  not  subject  to  review  in  the  light 
of  further  facts. 

How  do  these  suggestions  apply  to  the  Ames  case?  The  fol¬ 
lowing  summary  attempts  to  embody  the  criticisms  and  review  of 
that  case  already  given  in  this  chapter: 

DIAGNOSTIC  SUMMARY 

May  19,  1909 

Ames,  Thomas  (38)  and  Jane  (28),  two  girls,  6  and  2,  and  Mrs.  Ames’  mother 

Difficulties  Defined:  Illness  of  breadwinner  from  tuberculosis,  no  savings. 
Ames  unwilling  to  take  needed  sanatorium  treatment,  wife  seconds  him.  Mrs. 
Ames  described  as  “frail”  (competent  report  needed).1  Older  child  “not  bright” 
in  school  (mental  examination  needed?). 

Causal  Factors:  Of  the  tuberculosis,  not  definitely  known.  (Family  history? 
Housing?  Conditions  of  man’s  work?)  Of  the  refusal  of  sanatorium  care,  Mrs. 
Ames’  failure  to  realize  man’s  condition,  and  her  fears  that  home  may  be  broken  up. 
Of  Alice’s  school  record,  not  known. 

Assets  and  Liabilities:  Assets — (1)  Man’s  temperate  habits  and  affection  for 
family.  (2)  Excellent  home  standards  of  family.  (3)  Dispensary’s  willingness  to 
co-operate  in  persuading  Ames  to  go  away.  (4)  Miss  Delancey’s  interest.  (5) 
Mrs.  Freeman,  the  wife’s  sister,  and  Joseph  Ames  are  able  to  help  with  relief;  other 
relief  resources  are  Caldwell’s  and  the  church.  Liabilities — (1)  Man  not  a  skilled 
worker,  highest  weekly  earnings  $12.  (2)  Needing  immediate  attention — Mrs. 

Ames’  opposition  to  sanatorium  care  as  above. 

3.  The  Time  Element.  The  omissions  in  the  Ames  record  that 
are  indicated  in  the  foregoing  diagnostic  summary  could  have  been 
accounted  for,  probably,  by  pressure  of  other  work.  Those  who 
know  most  about  the  well-nigh  intolerable  conditions  under 
which  case  work  is  done — conditions,  that  is,  of  too  many  clients 
and  of  continual  hurry — will  make  large  allowance  for  short¬ 
comings.  Even  in  normal  seasons  the  demand  for  good  social 
case  work  is  so  fitful  that  it  cannot  assure  the  conditions  essential 
to  good  work.  In  periods  of  industrial  depression,  of  war,  of 
epidemic,  or  of  other  abnormal  pressure,  standards  that  have  been 
established  laboriously  are  not  only  battered  down  by  the  stress 
of  the  time  but  remain  down  long  after  the  occasion  has  passed. 
This  is  owing  in  part  to  the  tendency  to  carry  over  into  ordinary 
times  habits  of  work  created  by  emergent  periods. 

In  spite  of  these  discouragements  the  case  worker  who  depresses 

1  Entries  in  parenthesis  indicate  omissions  in  the  inquiry. 

361 


SOCIAL  DIAGNOSIS 


himself  and  others  by  an  attitude  of  skepticism  toward  progress 
forgets  that  he  is  not  alone  in  facing  difficulties.  Most  of  the 
world’s  advances  in  skill  have  been  made  under  pressure.  They 
have  been  made  by  the  exceptional  man  or  woman  who  has  de¬ 
veloped  judgment  in  eliminating  matters  of  lesser  importance  from 
the  work  before  him  through  sheer  strength  of  desire  to  work  out 
his  ideas.  The  exceptional  teacher,  physician,  social  worker  has 
repeatedly  established  and  advanced  standards  in  this  way.  And 
one  need  not  be  unusually  gifted  to  try  two  experiments  in  con¬ 
nection  with  his  own  work  which  will  have  a  steadying  influence 
upon  standards. 

The  first  experiment  has  just  been  suggested;  namely,  that  as 
soon  as  a  period  of  special  pressure  is  passed  the  worker  should 
set  himself  to  overcome  those  lax  methods  and  mental  habits 
which  emergency  conditions  have  forced  upon  him. 

The  second  experiment  is  suggested  by  Dr.  Adolf  Meyer,  pro¬ 
fessor  of  psychiatry  at  Johns  Hopkins.  Dr.  Meyer  teaches  stu¬ 
dents  specializing  in  mental  diseases  that  there  is  a  subjective 
reaction  toward  better  work  in  all  their  cases  if  they  are  careful 
to  get  a  complete  picture  in  a  minority  of  them.  In  social  work, 
also,  experiment  shows  that  the  habit  of  covering  the  ground  with 
especial  thoroughness  in  a  few  cases  affects  a  worker’s  standards 
with  all.  He  may  not  be  able  to  give  any  more  time  to  the  ma¬ 
jority  of  his  clients  after  this  tonic  exercise  than  before,  but  his 
judgments  about  them  will  be  more  penetrating.  This  result  is 
so  beneficent  and  far-reaching  that  every  case  worker  should  con¬ 
trive  to  secure  at  some  time  during  his  crowded  days  a  few  undis¬ 
turbed  hours,  a  little  center  of  quiet  into  which  he  may  bring 
selected  tasks  to  be  worked  out  studiously,  and,  if  possible,  to  a 
successful  issue. 

Such  concentrated  attention  produces  another  reaction  which 
extends  beyond  the  worker  himself  and  his  own  achievement. 
Good  work  creates  a  demand  for  more  work  of  the  same  grade, 
thus  exerting  an  influence  which  tends,  as  it  spreads,  to  change 
for  the  better  the  conditions  under  which  social  work  is  done. 
Boards  of  directors  become  awakened  to  the  fact  that  thorough 
work  means  results,  and  are  then  ready  to  do  their  part  toward 
supplying  enough  workers  to  maintain  standards. 

362 


COMPARISON  AND  INTERPRETATION 


An  after-care  worker  for  a  girls’  reformatory  found  that  the  reformatory  authori¬ 
ties  were  satisfied  with  meager  reports  of  the  girls’  previous  histories.  In  special 
instances  at  first — instances  in  which  the  authorities  could  see  at  a  glance  the  sig¬ 
nificance  of  a  fuller  history — she  began  to  supply  written  data.  The  result  was 
that  gradually  the  management  came  to  demand  and  to  make  provision  for  obtaining 
more  detail  for  all  inmates.  By  assuring  a  better  understanding  of  each  girl’s 
individual  problems  not  only  the  after-care  work  but  the  treatment  of  inmates  of 
the  institution  was  reshaped. 

4.  Full  Diagnosis  Not  Always  Possible.  Last  of  all,  full  diag¬ 
nosis — any  correct  diagnosis  in  fact — is  not  always  possible,  even 
when  there  is  ample  time.  We  are  dealing  with  human  factors 
and  we  too  are  human.  We  cannot  hope  that  the  processes  here 
described  will  always  bring  the  truth  to  light  or  reveal  the  possi¬ 
bilities  of  treatment.  Try  as  we  may,  certain  cases  will  remain 
obscure.  When  this  happens  we  must  trust  in  part  to  further 
acquaintance  with  our  client  and  in  part  to  temporary  treatment 
of  some  kind  which  will  itself  become  a  form  of  investigation. 

Be  it  repeated,  no  diagnosis  is  final.  Since  later  developments 
in  a  case  may  clarify  the  social  practitioner's  insight  into  its  causal 
factors,  there  is  a  sense  in  which  investigation  continues  as  long  as 
does  treatment. 

SUMMARY  OF  THIS  CHAPTER 

1.  First  we  collect  our  material,  next  we  compare  each  part  with  all  the  other 

parts,  and  then  we  interpret  it, _ .This  last  is  diagnosis. 

2.  Social  diagnosis  may  be  described  as  the  attempt  to  make  as  exact  a  definition 
as  possible  of  the  situation  and  personality  of  a  human  being  in  some  social  need — - 
of  his  situation  and  personality,  that  is,  in  relation  to  the  other  human  beings  upon 
whom  he  in  any  way  depends  or  who  depend  upon  him,  and  in  relation  also  to  the 
social  institutions  of  his  community. 

3.  There  has  been  too  little  relation,  heretofore,  between  material  gathered  and 
its  interpretation.  This  is  due  to  neglect  of  the  process  of  critical  comparison. 

4.  Comparison  of  data  should  include  review  of  each  item  with  all  the  others  in 
mind,  and  sometimes  review  of  each  with  all  other  items  deliberately  excluded. 
It  must  guard  against  overemphasizing  the  fact  established  with  difficulty,  against 
hidden  contradictions,  and  against  overemphasizing  first  and  last  statements 'and 
hypotheses.  It  must  retest  carefully  the  inferences  that  have  underlain  the  con¬ 
duct  of  the  inquiry  so  far.  The  questionnaire  for  Supervision  and  Review  in  Part 
III  gives  detailed  suggestions  for  the  comparison  of  data. 

5.  It  is  possible  to  make  all  these  comparisons  painstakingly  and  arrive  nowhere. 
The  “working  machinery”  of  diagnosis  does  not  assure  results  where  imaginative 
insight  is  lacking. 


363 


SOCIAL  DIAGNOSIS 


6.  A  good  social  diagnosis  is  at  once  full  and  clear,  with  emphasis  placed  upon  the 
features  which  indicate  the  social  treatment  to  be  followed. 

7.  The  one-word  diagnosis  which  is  a  mere  classification  is  of  little  value,  but  a 
detailed  diagnosis  can  also  be  valueless  if  it  misses  the  very  factors  that  are  working 
most  mischief  in  the  case  under  consideration. 

8. ^ Not  only  must  a  social  diagnosis  define  clearly  the  difficulty  or  difficulties; 
it  must  also  bring  together  those  elements  in  the  situation  which  may  become  ob¬ 
stacles  or  aids  in  the  treatment. 

9.  The  form  of  diagnostic  summary  may  have  to  be  varied  for  different  types  of 
social  case  work,  probably,  but  generally  it  will  include  (1)  a  definition  of  the  diffi¬ 
culties,  (2)  a  listing  of  the  causal  factors,  so  far  as  known,  that  enter  into  these 
difficulties,  (3)  an  enumeration  of  the  assets  available  and  the  liabilities  to  be  reck¬ 
oned  with  in  treatment. 

10.  There  are  two  experiments  that  may  help  to  control,  in  part,  the  trouble¬ 
some  time  element  in  diagnosis:  (1)  To  watch  for  and  check  the  tendency  to  carry 
over  emergency  period  habits  into  times  that  are  not  emergent.  (2)  To  cover  the 
ground  in  a  minority  of  cases  with  especial  thoroughness. 

11.  Full  diagnosis — any^correct  diagnosis  in  fact — is  not  always  possible,  and  no 
diagnosis  is  final. 


CHAPTER  XIX 

THE  UNDERLYING  PHILOSOPHY 


ALTHOUGH  mention  has  been  made  more  than  once  in 
earlier  chapters  of  the  interdependence  of  individual  and 
L  mass  betterment,  it  will  not  be  amiss,  in  bringing  this  long  ^ 
discussion  of  the  diagnostic  process  to  a  close,  to  re-enforce  briefly 
the  position  already  taken  that  social  reform  and  social  case  work 
must  of  necessity  progress  together.  We  have  seen,  for  example, 
that  the  diagnostic  side  of  case  work  received  a  great  impetus  when 
the  plans  of  reformers  began  to  be  realized,  and  that  social  work 
immediately  had  at  its  command  more  varied  resources  than  it 
could  apply  without  further  knowledge  of  the  differences  between 
men.1  To  understand  these  differences  and  adapt  its  working 
programs  to  them,  account  has  had  to  be  taken  of  men’s  social 
relationships. 

Less  emphasis  is  placed  in  these  pages  upon  the  other  side,  upon 
the  number  of  social  reforms  that  have  been  direct  outgrowths  of 
case  work,  and  the  number  that  owe  to  this  work  either  effective 
amendment  or  successful  administration.  There  are  few  adminis¬ 
trative  tasks  in  the  social  field,  in  fact,  which  do  not  have  to  utilize  r 
some  form  of  social  diagnosis  and  treatment.  A  new  piece  of  social^ 
legislation  may  give  case  work  a  new  direction,  it  almost  always 
modifies  such  work,  and  sometimes  renders  it  unnecessary  in  a 
given  field.  This  last  eventuality,  however,  is  predicted  many 

times  for  once  that  it  is  realized. 

,  * 

When,  for  example,  the  restriction  of  child  labor  was  made 
possible,  several  new  kinds  of  case  work  became  necessary,  one  of 
them  involving  greater  skill  in  sifting  the  yflriong 
one  involving  the  development  of  other  family  plans  to  take  the 
place  of  children’s  earnings,  etc.  The  methods  of  many  agencies 
engaged  in  case  work  were  modified  by  these  child  labor  measures. 

In  some  states,  on  the  other  hand,  data  supplied  by  the  agencies 
pointed  the  way  for  improvement  in  the  new  laws.  Discussing  this 
subject  of  the  relation  of  case  work  Jo  social  reform  at  a  recent 

^See  p.  32. 

365 


SOCIAL  DIAGNOSIS 


session  of  the  National  Conference  of  Charities  and  Correction,1  the 
writer  ventured  the  opinion  that  workmen's  compensation  laws 
belonged  to  the  type  of  social  legislation  which  rendered  further  case 
work  for  one  group  unnecessary.  But  in  the  debate  which  followed 
several  people  were  on  their  feet  at  one  time  to  bring  forward  in¬ 
stances  in  which  case  workers  had  not  only  had  to  make  adaptations 
of  the  existing  compensation  laws  to  individual  cases,  but,  in  so  do¬ 
ing,  had  discovered  points  at  which  these  laws  should  be  amended. 
Nfln  any  consideration  of  the  readjustments  necessary  from  time 
to  time  between  social  diagnosis  and  treatment  on  the  one  hand 
and  social  research  and  prevention  on  the  other,  analogies  drawn 
from  recent  developments  in  medical  science  and  practice  are 
inevitable.  As  between  laboratory  discovery  and  bedside  prac¬ 
tice,  for  instance.  Dr.  Lewellys  F.  Barker  summed  up  the^ituation 
a  few  years  ago,2  making  among  other  points  the  following:  Many 
of  the  teachers  and  investigators  in  the  purely  laboratory  branches 
of  medicine  are  men  of  limited  clinical  experience  or  none  at  all, 
while  the  clinical  branches  themselves  are  becoming  more  highly 
specialized.  As  everyone  knows,  there  has  been  almost  explosive 
progress  in  the  laboratory  branches,  but  laymen  are  not  so  familiar 
with  the  important  fact  emphasized  by  Dr.  Barker  that  new  medi¬ 
cal  discoveries  may,  and  often  do,  lie  unapplied  for  long  until  clinical 
medicine  has  been  developed  to  a  point  where  it  can  adapt  and 
apply  them.\  “The  Wassermann  reaction  may  be  primarily 
worked  out  in  a  non-clinical  laboratory,  but  the  determination  of 
its  real  significance  for  the  diagnosis  and  treatment  of  disease  de¬ 
mands,  subsequently,  long  years  of  clinical  research."  Scientific 
clinical  work  will  suffer  loss,  in  Dr.  Barker’s  opinion,  “if  the  men 
who  are  presumably  cultivating  the  clinical  sciences  of  diagnosis 
and  therapy  overlook  their  own  legitimate  problems."  These 
problems  are  “tasks  set  by  the  patients  themselves  .  .  . 

these  living  patients  are,  primarily,  the  objects  of  study  of  the 
clinical  scientist."  Meanwhile  the  air  is  thick  with  “applicable 
facts,  of  the  most  diverse  origin,"  and  “only  the  younger  clinicians 

1  See  Proceedings  of  the  National  Conference  of  Charities  and  Correction  for 
1915  (Baltimore),  p.  43  sq. 

2  Presidential  address  before  the  Association  of  American  Physicians.  Science, 
May  16,  1913. 

366 


THE  UNDERLYING  PHILOSOPHY 


have  had  opportunity  for  securing  a  training  permitting  of  an 
understanding  of  even  a  part  of  them/' 

It  would  be  easy  to  push  this  analogy  too  far,  to  urge  too  in¬ 
sistently  that  applicable  knowledge  is  not  being  applied  in  the 
social  field  because  we  have  failed  to  stimulate  original  and  pro¬ 
gressive  work  among  social  practitioners  to  the  extent  that  we 
should.  The  important  fact  for  us  is  that,  while  readjustments  are 
dearly  necessary,  diagnosis  and  therapy  do  assuredly  assume,  wit h 
each  advance  in  social  reform,  each  gain  of  scientific  medicine,  not 
less  but  more  importance  in  both  fields.  If,  as  we  have  seen,  the 
one-word  diagnosis  of  our  case  work  cannot  be  social,  neither  can 
the  single  reform  put  forward  to  cure  all  the  ills  of  society.  There 
is,  in  fact,  more  resemblance  than  either  would  admit  between  the 
mental  habits  of  the  case  worker  who  contentedly  treats  one  in¬ 
dividual  after  another,  one  family  after  another,  without  giving  a 
thought  to  the  civic  and  industrial  conditions  that  hedge  them 
about,  and  the  mental  habits  of  the  reformer  who  is  sure  that  the 
adoption  of  his  particular  reform  will  render  all  social  case  work 
unnecessary.  Both  ignore  the  complexity,  the  great  diversity,  of 
the  materials  with  which  they  are  attempting  to  deal. 

This  diversity  of  man's  life  is  made  clearer  on  its  mental  side  and 
in  its  relation  to  our  subject  by  certain  concepts  of  modern  psy¬ 
chology.  Two  of  these,  in  fact,  may  be  said  to  constitute  the 
underlying  philosophy  of  social  case  work;  they  explain  the 
necessity  for  its  continuing  survival  in  some  form.  The  first 
relates  to  the  fact  of  individual  differences,  the  second  to  the 
theory  of  “the  wider  self/' 

I.  INDIVIDUAL  DIFFERENCES 

Not  that  the  resemblances  among  men  are  socially  unimportant ; 
resemblances  have  made  mass  betterment  possible,  while  individu¬ 
ality  has  made  adaptation  a  necessity.1  In  the  early  stages  of  a 
democracy,  doing  the  same  thing  for  everybody  seems  to  be  the 
best  that  administrative  skill  is  equal  to,  but  later  we  learn  to  do 

1  “  Even  if  man’s  nature  included  only  five  traits,  a,  b,  c,  d,  and  e,  and  even  if 
each  of  the.e  existed  in  only  five  degrees,  i,  2,  3,  4,  and  5,  there  could  be  over  three 
thousand  (3,125,  to  be  exact)  varieties  of  men.  .  .  .  Hygiene,  medicine,  edu¬ 

cation,  and  all  social  forces  have  to  reckon  with  original  differences  in  men.” 
E.  L.  Thorndike,  Individuality,  pp.  19  and  43. 

367 


SOCIAL  DIAGNOSIS 


different  things  for  and  with  different  people  with  social  better¬ 
ment  clearly  in  view.  Our  public  schools  of  a  generation  ago  prided 
themselves  upon  treating  all  alike — whereas  reports  of  recent  school 
investigations  show  that  it  is  the  differentiated  treatment  of  the 
school  child  which  now  possesses  the  minds  of  educational  reformers.1 

It  seems  unnecessary  to  illustrate  further  the  truth  of  this  first 
concept,  but  that  of  the  second  one,  relating  to  the  wider  self,  is 
not  so  obvious. 


II.  THE  WIDER  SELF 

Individual  differences  must  be  reckoned  with  in  every  field  of 
endeavor,  but  the  theory  of  the  wider  self,  though  it  has  of  course 
other  implications,  seems  to  lie  at  the  base  of  social  case  work. 
We  have  seen  how  slowly  such  work  has  abandoned  its  few  general 
classifications  and  tried  instead  to  consider  the  whole  man.  Even 
more  slowly  is  it  realizing  that  the  mind  of  man  (and  in  a  very  real 
sense  the  mind  is  the  man)  can  be  described  as  the  sum  of  his 
social  relationships. 

Mrs.  Helen  Bosanquet  expresses  this  for*  the  layman  more 
clearly — perhaps  because  she  is  a  social  worker — than  others  who 
have  written  about  it.  She  says: 

"^■fThe  soul  literally  is,  or  is  built  up  of,  all  its  experience;  and  such  part  of  this 
experience,  or  soul  life,  as  is  active  at  any  given  time  or  for  any  given  purpose  con¬ 
stitutes  the  self  at  that  time  and  for  that  purpose.  We  know  how  the  self  enlarges 
and  expands  as  we  enter  upon  new  duties,  acquire  new  interests,  contract  new  ties 
of  friendship;  we  know  how  it  is  mutilated  when  some  sphere  of  activity  is  cut  off, 
or  some  near  friend  snatched  away  by  death.  It  is  literally,  and  not  metaphorically, 
a  part  of  ourselves  which  we  have  lost.2 

1  For  example,  take  the  following  by  Leonard  P.  Ayres  in  the  Proceedings  of  the 

Fifty-second  Annual  Meeting  of  the  National  Education  Association,  1914,  p. 
278:  “In  every  school  system  there  is  greater  difference  in  class  room  ability  be¬ 
tween  different  members  of  the  same  grade  than  there  is  between  the  abilities  of  the 
average  children  in  the  lowest  and  the  average  children  in  the  highest  grades. 
.  .  .  This  means  that  ...  we  must  differentiate  our  courses  because  our 

courses  are  made  for  our  children,  and  our  children  are  differentiated  by  nature.” 

Or  the  following  by  Paul  H.  Hanus  in  School  Efficiency,  A  Constructive  Study 
Applied  to  New  York  City,  p.  15:  “Over  and  above  the  foregoing  suggestions  for 
the  improvement  of  the  course  of  study  in  certain  details  is  .  .  .  the  adjust¬ 

ment  of  the  entire  course  of  study  to  individual  and  local  needs  throughout  the 
city.  The  differences  in  respect  to  individual  and  local  needs  in  New  York  City 
with  its  heterogeneous  population  are  very  great,  and  they  are  not  now  satisfac¬ 
torily  taken  into  the  account.”  Yonkers,  N.  Y.,  World  Book  Co.,  1913. 

2  Bosanquet,  Mrs.  Helen:  The  Standard  of  Life  and  Other  Studies,  p.  13 1. 
London,  Macmillan  and  Co.,  1898. 


368 


THE  UNDERLYING  PHILOSOPHY 


That  we  may  know  a  man  by  the  company  he  keeps  is  a  maxim 
of  which  Polonius  might  have  been  the  author.  But  it  has  a  deeper 
meaning  than  the  conventional  one./  A  man  really  is  the  company 
he  keeps  plus  the  company  that  his  ancestors  kept.)  He  is  “ co¬ 
extensive  with  the  scope  of  his  conscious  interests  and  affections.” 
These  interests  change  inevitably.  In  fact,  change  is  one  of  the 
conditions  of  their  continuing  healthfulness,  though  change  may 
mean  either  contraction  and  loss  or  the  widening  of  interests,  the 
strengthening  of  social  ties.1 

Although  the  preliminary  inquiries  of  social  agencies  are  still 
conducted  from  other  motives,  many  of  the  more  thoughtful  case 
workers  of  today  are  learning  to  study  the  relations  of  individual 
men  in  the  light  of  this  concept  of  the  wider  self— of  the  expanding 
self,  as  they  like  to  believe.  In  so  doing,  they  are  allying  them¬ 
selves  with  the  things  that  “move,  touch,  teach”;  for  where  dis¬ 
orders  within  or  without  threaten  a  man’s  happiness,  his  social 
relations  must  continue  to  be  the  chief  means  of  his  recovery. 
Many  years  before  these  ideas  were  formulated  by  science  they 

1  This  conception  of  the  wider  self  is  described  in  varying  terms  by  different 
psychologists.  The  two  following  passages  may  be  taken  as  representative: 

James  Mark  Baldwin:  The  thought  of  self  arises  directly  out  of  certain  given 
social  relationships;  indeed,  it  is  the  form  which  these  actual  relationships  take  on 
in  the  organization  of  a  new  personal  experience.  The  ego  of  which  he  thinks  at 
any  time  is  not  the  isolated-and-in-his-body-alone-situated  abstraction  which  our 
theories  of  personality  usually  lead  us  to  think.  It  is  rather  a  sense  of  a  network 
of  relationships  among  you,  me,  and  the  others,  in  which  certain  necessities  of 
pungent  feeling,  active  life,  and  concrete  thought  require  that  I  throw  the  emphasis 
on  one  pole  sometimes,  calling  it  me;  and  on  the  other  pole  sometimes,  calling  it  you 
or  him.  Social  and  Ethical  Interpretations  in  Mental  Development,  p.  508  sq. 

Edward  L.  Thorndike:  About  fifteen  years  ago  the  point  of  view  of  students  of 
human  nature  showed  the  first  clear  signs  of  what  has  been  a  rather  abrupt  change 
— toward  thinking  of  a  man’s  mind  as  the  sum  total  of  connections  between  the 
situations  which  life  offers  and  the  responses  which  the  man  makes.  Up  till  then 
the  mind  had  been  thought  of  primarily  as  a  set  of  magical  faculties  or  powers — 
attention,  memory,  inference,  reasoning,  choice,  and  the  like — or  as  a  collection  of 
certain  contents — sensations,  images,  thoughts,  volitions,  and  the  like.  Today  the 
progressives  in  psychology  think  of  a  man’s  mind  as  the  organized  system  of  con¬ 
nections  or  bonds  or  associations  whereby  he  responds  or  reacts  by  this  or  that 
thought  or  feeling  or  act  to  each  of  the  millions  of  situations  or  circumstances  or 
events  that  befall  him.  Their  customary  name  for  the  mind  is  the  connection- 
system;  their  ideal  of  psychology  is  a  science  which  can  predict  what  any  given 
situation  or  stimulus  will  connect  with  or  evoke  in  the  way  of  thought,  feeling, 
word,  or  deed;  their  offering  to  education  is  an  offering  of  knowledge  of  the  laws 
whereby  connections  in  thought  and  behavior  are  made  and  broken,  are  preserved 
and  weakened,  and  are  of  help  and  hindrance  one  to  another.  The  Foundations 
of  Educational  Achievement,  The  Educational  Review,  December,  1914,  pp.  487-8, 
Vol.  48,  No.  5. 

24 


369 


SOCIAL  DIAGNOSIS 


were  applied  to  housing  reform,  to  neighborhood  improvement, 
and  to  case  work  by  Miss  Octavia  Hill,  whose  relation  to  the  be¬ 
ginnings  of  social  diagnosis  has  been  described  in  the  first  chapter. 
Hers  was  a  conception  so  sound  and  so  inspired  that  science  came 
later  not  to  correct  but  to  fulfill  it. 

It  will  still  be  necessary  to  do  different  things  for  and  with 
different  people,  and  to  study  their  differences,  if  the  results  of  our 
doing  are  to  be  more  good  than  bad.  It  will  still  be  necessary  to 
study  the  social  relations  of  people,  not  only  in  order  to  under¬ 
stand  their  differences  but  in  order  to  find  a  remedy  for  the  ills 
that  will  continue  to  beset  them.  These  ills  will  change  their 
form,  some  will  be  blotted  out,  and  the  whole  level  of  life,  as  we 
have  a  right  to  hope,  will  be  lifted.  Although  the  level  upon  which 
the  case  worker  operates  will  also  be  raised,  case  work  will  still  be 
needed;  its  adaptation  of  general  principles  to  specific  instances 
will  not  be  automatic  nor  will  good  administration  become  so. 
It  may  also  be  predicted  that  the  forms  of  organization  now  re¬ 
sponsible  for  case  work  will  change,  that  its  scope  and  skill  will 
advance  far  beyond  the  present-day  practice  described  in  this 
study.  The  methods  and  processes  here  dwelt  upon  will  sub¬ 
ordinate  themselves  to  a  larger  whole.  It  is  only  through  devo¬ 
tion  to  that  whole — not  through  any  narrow  insistence  upon 
technique  alone — that  we  can  submit  ourselves  in  the  right  spirit 
to  the  task  of  analyzing  individual  situations.  But  we  must  come 
under  the  law  before  we  can  rise  above  it. 


PART  III 


VARIATIONS  IN  THE  PROCESSES 


CHAPTER  XX 


SOCIAL  DISABILITIES  AND  THE  QUESTIONNAIRE 

PLAN  OF  PRESENTATION 


WHEN  the  case  worker  has  gone  only  a  short  distance 
in  his  preliminary  inquiries,  or  sometimes  at  a  later 
period,  he  discovers  a  certain  disability  or  a  combina¬ 
tion  of  disabilities.  What  are  the  implications  of  his  discovery? 
How  should  it  modify  his  method?  By  what  means  can  a 
large  number  of  possible  modifications  be  indicated  and  made 
accessible  for  reference  when  needed?  This,  next  to  the  discus¬ 
sion  of  evidence,  has  been  the  most  difficult  problem  with  which  the 
present  study  has  had  to  deal.  Our  discussion  of  the  methods  and 
points  of  view  common  to  all  social  diagnosis  is  ended,  but  there 
remains  to  be  treated  this  baffling  topic  of  the  variations  in  method 
demanded  by  different  tasks  and  by  the  presence  of  different 
disabilities. 


I.  OBJECTS  OF  THE  QUESTIONNAIRES 
1.  Their  Dangers.  In  determining  to  present  in  questionnaire 
form  most  of  the  material  gathered  for  this  final  division  of  the 
subject,  the  writer  is  aware  that  the  device  is  clumsy  and  that  it 
has  its  dangers.  The  purposes  and  limitations  of  these  question¬ 
naires  are  bound  to  be  misunderstood  by  some  who  attempt  to 
use  them,  no  matter  how  clearly  it  is  set  forth  that  none  are  sets 
of  questions  to  be  asked  of  clients  and  that  none  are  schedules 
the  answers  to  which  are  to  be  filled  in  by  anyone.  They  are 
merely  long  lists  of  queries  which,  when  gone  over  by  the  social 
case  worker  with  a  particular  case  in  mind,  may  bring  to  his  atten¬ 
tion,  out  of  the  many  presented,  a  possible  four  or  five  that  may 
contain  suggestive  leads. 

Leading  questions  are  dangerous  things,  as  already  indicated; 
the  questioner,  ignorant  of  the  true  answer,  suggests  one  never¬ 
theless  to  the  person  who  is  being  questioned.  Here  the  case 

373 


SOCIAL  DIAGNOSIS 


worker  is  asking  himself  questions.  He  is  merely  doing  more 
formally,  in  fact,  what  he  is  forced  to  do  all  the  time,  for  social 
diagnosis  moves  forward  by  calling  up  before  the  mind  one  possible 
explanation  after  another,  one  alternative  after  another,  before 
putting  each  to  the  test.  It  is  in  the  suggestion  of  alternative 
situations  and  explanations  that  these  questionnaires  will,  it  is 
hoped,  prove  of  some  help.  Their  very  extent  and  elaboration 
should  make  it  evident  that  no  one  of  them  could  apply  in  its  en¬ 
tirety  to  any  one  client  or  any  one  family.  But  it  may  be  added 
that  they  have  no  significance  and  will  seem  only  a  confused  mass 
of  detail  unless  they  are  examined  with  a  particular  case  in  mind. 
In  a  case  in  which  the  first  interview  has  been  held  and  certain 
data  have  been  gathered  elsewhere,  the  choice  of  questionnaires  to 
be  examined  should  not  be  difficult.  The  preliminary  question¬ 
naire  regarding  Any  Family  takes  precedence  (if  there  is  a  family) 
of  the  questionnaires  covering  the  particular  disability  or  dis¬ 
abilities. 

2.  Their  Use  Illustrated.  Thus,  the  Angelinos  are  a  family, 
and  that  fact  may  justify  taking  the  time  to  read  over  the  first 
questionnaire  in  order  to  be  sure  that  no  important  point  which 
seems  to  bear  upon  their  present  difficulties  has  been  omitted. 
Many  of  the  questions  are  disposed  of  at  once  as  not  applying,  as 
applying  but  unimportant,  or  as  already  followed  up,  but  a  few  of 
those  which  remain  may  raise  a  doubt  of  the  course  that  the  in¬ 
quiry  has  taken  so  far  and  suggest  another  way.  The  Angelinos 
are  not  just  a  family,  however,  they  are  a  family  recently  arrived 
in  this  country.  What  does  that  fact  suggest  with  regard  to  their 
background  and  foreground?  The  Immigrant  Family  Question¬ 
naire  is  necessarily  general,  but  it  may  yield  a  few  ideas.  The 
oldest  girl  is  blind  and  has  had  no  care.  Unless  the  case  worker 
knows  just  where  to  turn  for  guidance  in  dealing  with  this  dis¬ 
ability  on  its  social  side,  Miss  Lucy  Wright’s  carefully  framed 
questions,  as  given  in  Chapter  XXV,  may  have  something  to  teach 
him.  A  good  deal  later  Angelino  leaves  home  without  giving  any 
clue  to  his  destination,  or  so  his  wife  says.  Possibly  the  Deserted 
Family  Questionnaire  may  throw  some  light  on  the  first  steps  to  be 
taken.  Neither  in  this  case  nor  in  any  other,  however,  are  these 
questionnaires  to  be  heavily  leaned  upon.  Anyone  who  has  had 

374 


THE  QUESTIONNAIRES 


the  patience  to  follow  the  earlier  discussions  of  this  book  will 
realize  that  it  does  not  put  forward  the  treatment  of  separate 
disabilities  as  the  whole  of  social  case  work  by  any  means.  The 
Angelinos  are  not  just  an  immigrant  family  or  a  deserted  family, 
and  the  case  worker  who  knows  them  as  well  as  their  disabilities 
is  the  one  who  will  have  most  success  in  the  diagnosis  and  treat¬ 
ment  of  their  social  situation. 

II.  WHAT  IS  TRUE  OF  EVERYBODY? 

Requests  often  came  to  us,  in  gathering  our  material,  for  a  good, 
comprehensive  outline  of  the  ground  that  should  be  covered  in 
any  social  diagnosis  whatsoever.  No  single  question  of  the  out¬ 
line  thus  asked  for  was  to  be  unimportant,  and  all  were  to  apply 
quite  universally  to  human  situations.  This  was,  in  effect,  a 
demand  for  a  short  cut,  and  there  are  no  short  cuts  in  diagnosis. 
Between  a  clear  conception  of  the  things  that  are  true  of  everybody 
and  an  equally  clear  conception  of  the  things  that  are  true  of  that 
complex  of  human  relations  and  experiences  represented  by  an 
individual  client,  anything  might  be  important,  and  there  are  few 
things  that  might  not  become  in  certain  circumstances  unimpor¬ 
tant. 

Studies  yet  to  be  made  will  undoubtedly  give  case  work  a  more 
solid  basis  of  formulated  and  applicable  experience,  but  such 
studies,  if  they  are  to  be  of  value,  cannot  begin  with  uniform 
schedules,  filled  out  by  different  agencies  and  workers — each 
with  a  different  notion  of  what  social  evidence  means  or  with  none 
at  all.  When  answers  obtained  in  this  way  are  added  together  to 
make  a  total,  the  result  is  meaningless.  A  more  fruitful  method 
of  case  work  study,  and  one  adaptations  of  which  will  probably 
be  tried  in  the  near  future  with  different  groups  of  cases,  is  that 
already  illustrated  by  Dr.  Healy’s  Individual  Delinquent  and  by 
Dr.  Cabot’s  Differential  Diagnosis.  The  former  gives  the  results 
of  diagnosis  and  treatment  in  1000  cases  of  juvenile  delinquency 
selected  on  the  basis  of  “repetition  of  offense  plus  sufficiency  of 
data”;  the  latter  classifies  383  case  histories  of  disease  by  what 
its  author  calls  their  “presenting  symptom” — by  the  one,  that  is, 
of  which  the  patient  was  most  acutely  aware  when  he  asked  medical 
aid,  such  as  a  backache,  a  chill,  a  headache,  etc.  “Cases  do  not 

375 


SOCIAL  DIAGNOSIS 


often  come  to  us  systematically  arranged/’  says  Dr.  Cabot,  ‘'like 
the  account  of  typhoid  in  a  text-book  of  practice  of  medicine. 
They  are  generally  presented  to  us  from  an  angle,  and  with  one 
symptom,  generally  a  misleading  one,  in  the  foreground.  From 
this  point  of  view  we  must  reason  our  way  back  into  the  deeper 
processes  and  more  obscure  causes  which  guide  our  therapeutic 
endeavor/’  With  Dr.  Cabot  “we”  means  the  medical  practi¬ 
tioners,  but  it  is  illuminating  to  us  as  well  as  to  them  to  see  dis¬ 
eases  of  the  most  diverse  origins  and  degrees  of  curability  thrust  in 
shoulder  to  shoulder,  jostling  one  another,  because  their  victims 
all  happened  to  complain  chiefly  of  a  headache,  for  instance.  As 
a  lesson  in  social  diagnosis,  the  book  carries  two  meanings — its 
obvious  meaning,  which  is  that  the  symptoms  of  physical  disease 
encountered  daily  in  the  course  of  social  work  need  the  most  ex¬ 
pert  medical  diagnosis,  and  its  deeper  meaning,  that  social  diagnosis 
must  also  be  expert,  must  also  reason  its  way  back  “into  the  deeper 
processes,”  and  push  beyond  surface  symptoms  to  their  causes. 

The  social  worker  needs  for  his  daily  task  two  kinds  of  equip¬ 
ment.  To  be  a  good  case  worker,  he  must  have  a  generous  con¬ 
ception,  and  one  filled  with  concrete  details,  of  the  "varied  possi¬ 
bilities  of  social  service,  and  this  conception  must  be  a  growing  one. 
It  must  grow  with  his  growing  experience  and  also  with  each  year’s 
freight  of  social  discovery.  And  quite  as  vividly,  quite  as  pro¬ 
gressively,  he  must  have  a  conception  of  the  possibilities  of  human 
nature — of  the  suggestibility,  improvability,  and  supreme  value  of 
folks.  The  former  conception  can  be  acquired;  it  comes  in  part 
from  sympathetic  study  of  the  constructive  programs  of  service 
already  well  represented  in  the  literature  of  social  work,  in  part 
from  the  use  of  such  technical  material  as  has  been  compiled  here, 
and  in  part  from  practical  work  under  progressive  leadership. 
But  the  latter  ‘conception  is,  in  a  sense,  part  of  himself.  What  he 
thinks  of  human  nature  is  bounded  by  what  he  knows  of  human 
nature,  and  what  he  knows,  in.  this  field,  is  bounded  by  what  he  is. 

What  are  the  things  that  are  true  of  everybody?  Or,  to  narrow 
the  question  somewhat,  What  is  true  of  everybody  living  under  the 
conditions  which  a  modern  civilization  imposes?  No  two  people 
will  answer  this  question  in  the  same  way,  but  the  mere  exercise 
of  trying  to  answer  it  will  clear  the  mind,  or  will  at  least  make  it 

376 


THE  QUESTIONNAIRES 


impossible  to  continue  to  record  as  facts  statements  that  cannot 
possibly  be  true  of  anybody. 

The  writer  used  to  give  this  question  as  an  exercise  to  workers 
in  training  with  interesting  results.  What  a  case  worker  “think- 
eth  in  his  heart"  about  the  life  of  the  individual  and  about  society’s 
responsibility  for  it  is  going  to  be  a  matter  of  commanding  influence 
in  his  daily  work.  The  question  is  one  which  each  worker  must 
answer  for  himself  and  in  his  own  way,  but  the  following  rather 
matter-of-fact  answer  is  given  here  as  being  more  or  less  in  key  with 
the  point  of  view  of  the  present  volume: 

We  all  have  a  birthday  and  a  place  of  birth,  and  have  or  have  had  two  parents, 
four  grandparents,  etc.,  with  all  that  this  implies  by  way  of  racial  and  national 
characteristics,  of  family  inheritance  and  tradition,  and  probably  of  family  environ¬ 
ment.  Our  place  of  birth  (assuming  here  and  elsewhere  the  conditions  of  a  modern 
civilization)  was  a  house  of  some  kind,  and  we  have  continued  to  live  in  this  or  in  a 
series  of  other  houses  ever  since.  The  characteristics  of  these  houses,  their  neigh¬ 
borhood  and  atmosphere,  have  helped  to  make  us  what  we  are. 

We  all  have  bodies  that  need  intelligent  care  if  we  are  to  keep  them  in  good  re¬ 
pair.  Their  condition  has  influenced  our  minds  and  our  characters,  though  it  is 
equally  true  that  these,  in  turn,  may  have  influenced  profoundly  our  bodily  health. 

We  have  all  had  an  education,  whether  through  instruction  in  the  schools  and 
in  the  churches,  or  through  means  less  formal. 

We  have  all  had  some  means  of  subsistence,  whether  through  gainful  occupa¬ 
tions  of  our  own,  through  dependence  upon  the  gainful  occupations  of  others,  or 
through  assistance  public  or  private. 

We  all  modify,  and  are  in  turn  modified  by,  our  material  and  our  social  environ¬ 
ment.  The  body  of  social  traditions,  institutions,  equipments  of  every  sort  that 
man  has  built  up  has  left  a  deep  mark  upon  him.  This  implies,  among  other 
things,  an  emotional  responsiveness  to  the  society  of  our  fellows — responsiveness 
whether  shown  in  marriage  and  the  founding  of  a  second  home  (in  which  case,  of 
course,  all  of  the  foregoing  things  are  true  also  of  the  one  married),  or  in  other 
associations  of  personal  loyalty  with  our  fellows,  individually  and  in  groups.  These 
attractions  imply  repulsions.  We  are  remoulded  by  the  discords  of  the  one,  the 
concords  of  the  other. 

We  are  all  going  somewhere  and  have  not  yet  arrived.  Our  character  is  “not 
cut  in  marble,”  but  is  the  sum  of  our  past  experiences — a  sum  which  is  to  be 
changed,  inevitably,  by  our  future  experiences. 

III.  WHAT  IS  POSSIBLY  TRUE  OF  ANY  FAMILY? 

As  already  said,  most  of  the  questionnaires  that  follow  are 
applicable  to  a  particular  disability,  and  are  confined  to  the  diag¬ 
nostic  aspects  of  that  disability.  But  the  line  between  diagnosis 

377 


SOCIAL  DIAGNOSIS 


and  treatment  cannot  be  drawn  strictly,  so  a  few  questions  bearing 
more  especially  upon  treatment  are  included;  and  the  first  and  the 
last  questionnaire  do  not  treat  of  disabilities  at  all.  The  first 
relates  instead  to  the  basic  facts  likely  to  be  true  of  most  families; 
the  last  is  framed  for  one  who  reviews  the  entries  of  a  case  record 
before  advising  as  to  the  next  steps  leading  to  diagnosis  or  as  to 
the  diagnosis  itself. 

The  family  rather  than  the  individual  has  been  made  the  sub¬ 
ject  of  this  preliminary  questionnaire,  because  the  work  to  be 
undertaken  is  social,  and  the  individual  in  whose  interest  the  lists 
of  questions  will  be  consulted  must  be  considered  primarily — 
whatever  his  disabilities  may  be — in  his  social  relationships. 
The  questions  of  this  preliminary  list  are  not  as  a  rule  repeated 
in  later  lists,  though  sometimes,  where  they  have  seemed  especially 
applicable,  they  have  had  to  be  repeated  for  emphasis.  It  is 
assumed,  however,  that  where  a  special  questionnaire  has  to  be 
consulted  this  first  one  will  also  be  included.  The  eleven  lists 
which  follow  it  are  not  poured  into  any  one  mould.  Their  classi¬ 
fication  is  not  uniform  nor  is  their  treatment.  It  will  be  seen  that 
they  are  the  product  of  different  hands  and  that  the  subjects  are 
too  diverse,  moreover,  to  have  made  uniform  treatment  advisable. 

QUESTIONNAIRE  REGARDING  ANY  FAMILY 

This  is  not  a  schedule  to  be  filled  out  nor  a  set  of  queries  to  be  answered  by  a 
social  agency’s  client  or  clients.  For  an  explanation  of  the  purpose  of  these  question¬ 
naires  see  p.  373  sq. 

A  star  (  *  )  indicates  that  the  answer  to  the  question  may  be  found  in,  or  confirmed 
by,  public  records. 

I  General  Social  Data 

1.  Family’s  name?  Wife’s  given  and  maiden  name?  Husband’s  given  name? 
Full  names  of  children?  Names  of  all  other  members  of  the  household,  and  their 
relation  to  the  family? 

2.  What  was  the  birthplace  of  husband,  of  wife,  and  of  each  child?  Nationality  of 
each  of  the  four  grandparents? 

3.  What  was  the  date  of  birth  of  husband,  of  wife,  and  of  each  child?* 

4.  What  were  the  conditions,  economic  and  moral,  in  the  husband’s  childhood 
home?  The  wife’s?  What  was  the  effect  of  these  conditions  on  his  or  her  health, 
character,  and  industrial  status? 

5.  How  long  have  they  been  in  the  city,  the  state,  and  the  country?  Reason  for 
each  migration?  Do  they  both  speak  English? 

378 


ANY  FAMILY 


6.  What  was  the  date  and  place  of  their  marriage?* 

7.  What  previous  marriages  had  either  contracted,  if  any?* 

8.  Has  there  been  any  divorce  or  legal  separation  and  on  what  grounds?*  Have 
any  of  the  children  been  placed  under  guardianship?*  Adopted?* 

9.  What  relatives  outside  of  the  household  have  husband  and  wife  (including  mar¬ 
ried  and  unmarried  children,  and  children  by  previous  marriages)?  What  are 
the  circumstances  of  these  relatives,  their  interest  in  the  family,  degree  of  influ¬ 
ence  with  the  family?  Names,  addresses,  degrees  of  relationship? 

10.  What  is  the  point  of  view  of  such  other  natural  sources  of  insight  as  friends, 
former  neighbors,  former  tradesmen  and  landlords,  priests  or  pastors,  fellow 
workmen  and  lodge  members,  etc.? 

1 1.  Has  the  trend  of  the  family  life  been  upward  or  downward?  What  character¬ 
istics  of  husband  or  wife,  or  what  circumstances  of  health,  employment,  etc.,  have 
determined  this  trend?  What  were  the  family  circumstances  and  characteristics 
when  the  family  was  at  its  best?  How  do  these  compare  with  its  present 
standard? 

12.  What  is  the  attitude  of  the  members  of  the  family  toward  one  another?  Do 
they  hang  together  through  thick  and  thin  or  is  there  little  cohesion? 

13.  Have  the  parents  good  control  over  the  children?  Have  they  their  confidences? 
Are  the  children  taught  consideration  of  the^rights  of  others? 

14.  What  are  the  children’s  aptitudes,  chief  interests,  and  achievements? 

II  Physical  and  Mental  Conditions 

15.  Did  the  parents  or  other  relatives  of  husband  or  wife  have  marked  mental, 
moral,  or  physical  defects?  Unusual  gifts  or  abilities?  What  facts,  if  any,  about 
the  husband  or  wife  or  their  parents  would  indicate  physical  or  mental  dangers 
to  be  guarded  against  or  special  capabilities  to  be  developed  in  the  children? 

16.  How  many  children  have  they  had?  Did  wife  have  any  miscarriages?  How 
many  children  have  died?  When  and  from  what  causes? 

17.  What  attention  is  given  to  personal  hygiene  and  health  in  the  family?  Are 
there  regular  meal  hours?  Do  the  food  expenditures  give  a  sufficient  and  well 
balanced  diet?  Is  the  importance  of  regular  sleep,  bathing,  care  of  the  teeth, 
and  regular  action  of  the  bowels  appreciated? 

18.  If  there  is  a  baby,  how  is  it  fed,  where  does  it  sleep,  how  much  is  it  in  the  open 
air  during  the  day?  If  the  wife  is  pregnant,  is  she  receiving  good  care? 

19.  What  is  the  present  physical  condition  of  each  member  of  the  family,  including 
also  bodily  and  mental  defects? 

20.  What  treatment  has  been  and  what  is  now  being  given  the  various  members 
by  physicians  and  medical  agencies,  and  with  what  results? 

III  Industrial  History 

21.  What  is  the  business  or  employment,  both  previous  and  present,  of  each  worker 
in  the  family?  What  are  the  names  and  addresses  of  employers,  previous  and 
present?  Between  what  dates  was  worker  employed  by  each?  What  were  his 

379 


SOCIAL  DIAGNOSIS 


earnings,  maximum  and  usual,  when  regularly  employed?  What  was  his  work 
record  at  these  places  for  speed,  accuracy,  regularity,  sobriety?  What  were  his 
reasons  for  leaving?  To  what  trade  union,  if  any,  does  he  belong?  Is  he  in 
good  standing? 

22.  At  what  age  did  each  member  of  the  family  go  to  work,  what  was  his  training, 
and  what  was  his  first  occupation?  Have  his  occupations  since  been,  on  the  whole, 
a  good  fit?  If  not,  is  he  capable  of  developing  greater  skill  at  something  else? 

23.  What  was  the  occupation  of  the  wife  before  marriage,  if  any,  and  wages  then? 

24.  Is  present  occupation  of  each  worker  regular,  seasonal,  or  occasional?  Is  there 
any  chance  of  advancement?  If  out  of  work,  how  long  and  why? 

25.  Are  the  conditions  under  which  each  member  of  the  family  works  good?  If 
not,  in  what  way  bad? 

IV  Financial  Situation  (exclusive  of  charitable  relief) 

26.  Income.  What  are  the  present  wages  and  earnings?  What  proportion,  in  each 
case,  goes  into  the  family  budget?  Is  this  proportion  too  large  or  too  small? 
Present  income  from  other  sources,  including  lodgers,  boarders,  pensions,  bene¬ 
fits,  contributions  from  relatives,  etc.?  Is  the  present  income  adequate?  Could 
the  present  income  be  increased  in  any  wise  way? 

27.  Outgo.  What  are  the  monthly  expenditures  for  food,  rent,  clothing,  fuel,  insur¬ 
ance,  carfare,  recreation,  sundries?  What  is  the  amount  of  debts,  to  whom,  for 
what?  Are  any  articles  in  pawn,  where,  amount  due?  Are  any  articles  being 
purchased  on  the  installment  plan?  Weekly  payments?  Amount  still  to  be  paid? 
With  what  insurance  company  are  members  of  family  insured?  What  is  the  total 
of  weekly  premiums?  Are  they  paid  up  to  date?  Could  the  present  expenditures 
be  decreased  in  any  wise  way?  Should  they  be  increased,  and  how? 

28.  Is  there  any  court  record  of  inheritance,  of  property,  of  insurance,  of  damages 
recovered?*  Has  the  family,  or  did  it  ever  have,  savings?  When,  where,  and 
how  much?  Do  any  members  belong  to  benefit  organizations?  Amount  of  dues, 
possible  benefits? 

V  Education 

29.  What  was  the  education  of  parents?  At  what  ages  did  they  and  the  older 
children  leave  school?  Did  the  children  have  any  vocational  training?  How 
does  the  education  of  each  member  of  the  family  compare  with  the  standards  of 
the  community  in  which  each  was  reared? 

30.  What  is  the  school  and  grade  of  each  child  of  school  age?  His  teacher's  name? 
School  evidence  as  to  scholarship,  attendance,  behavior,  physical  and  mental 
condition,  and  home  care? 

VI  Religious  Affiliations 

31.  What  is  the  religion  of  each  parent?  Name  of  church?  What  signs  are  there 
of  its  influence? 

32.  Do  children  receive  religious  instruction  in  Sunday  schools,  or  otherwise? 
Where  and  from  whom?  Where  were  they  baptized? 

380 


% 


ANY  FAMILY 


VII  Recreation 

33.  What  social  affiliations  have  the  various  members  of  the  family?  Do  any  of 
them  belong  to  clubs  or  societies — church,  settlement,  fraternal,  political,  or 
other?  What  forms  of  recreation  do  the  family  enjoy  together?  What  sepa¬ 
rately?  How  does  each  member  employ  his  leisure  time? 

VIII  Environment 

34.  Does  family  occupy  a  whole  house?  If  so,  has  it  a  yard?  A  garden?  If  not, 
on  what  floor  do  they  live?  At  front  or  rear?  How  many  rooms?  Name  and 
address  of  landlord  or  agent? 

35.  Are  the  rooms  adequately  lighted  and  ventilated?  What  are  the  toilet  and 
water  facilities?  The  general  sanitary  condition  of  the  house? 

36.  Are  the  rooms  comfortably  furnished?  Are  they  clean,  or  sordid  and  dirty? 

37.  What  is  the  character  of  the  neighborhood?  Has  it  undesirable  physical  or 
moral  features?  How  many  other  families  in  the  house?  Their  general  char¬ 
acter? 

38.  How  long  has  family  lived  at  present  address?  At  what  previous  addresses 
has  family  lived?  When  and  how  long?  Character  of  each  neighborhood  and 
house? 

IX  Relations,  If  Any,  with  Social  Agencies 

39.  Have  any  social  agencies  or  institutions  had  relations  with  the  family?  If  so, 
of  what  kind  and  with  what  results?  If  first  contacts  have  been  with  the  wife, 
is  the  husband  known  also,  or  vice  versa?  To  what  extent  has  the  family  re¬ 
ceived  charitable  aid,  if  at  all? 

X  Basis  for  Treatment 

40.  What  are  the  family’s  plans  and  ambitions  for  the  future?  What  moral  and 
temperamental  characteristics  and  what  aptitudes  of  each  member  can  be  reck¬ 
oned  with  as  assets  or  must  be  recognized  as  liabilities  in  the  shaping  of  that 
future? 


381 


CHAPTER  XXI 


THE  IMMIGRANT  FAMILY 

HE  RECENT  immigrant  has  been  mentioned  a  number  of 
times  in  these  chapters  in  connection  with  such  topics  as 
the  “funded  thought”  of  peasant  witnesses,  the  attitude 
of  the  alien  toward  our  social  agencies,  the  search  for  data  in  foreign 
birth  records,  in  immigration  records,  etc.  These  comments  will 
not  be  repeated;  they  can  be  readily  referred  to  with  the  aid  of 
the  index.  Passages  in  earlier  pages  bearing  upon  topics  discussed 
in  the  chapters  which  follow  are  made  available  in  the  same  way. 

In  dealing  with  foreign  clients,  the  case  worker  finds  himself  in 
danger  of  falling  into  one  of  two  errors:  he  may  think  of  them  as 
members  of  a  colony  or  of  a  nationality  having  such  and  such 
fixed  characteristics,  or  he  may  ignore  national  and  racial  char- 
r  acteristics  and  try  to  apply  to  them  the  same  standards  of  measure 
that  he  would  apply  to  his  fellow-countrymen.  He  is  liable  to 
surprises  if  he  adopts  the  latter  course.  Before  long,  he  will 
have  learned  that  he  cannot  ignore  national  characteristics  al¬ 
together.  But  only  extended  experience  will  teach  him  to  be  as 
discriminating  in  ascribing  such  characteristics  to  others  as  he 
would  wish  his  own  adviser  to  be  were  he  a  stranger  in  a  strange 
land  and  in  difficulties.  Generalizations  about  Americans,  ap¬ 
plied  to  himself  in  such  a  case,  might  strike  him  as  beside  the 
mark. 

Let  us  suppose  instead  that  he  is  suddenly  transferred  from  ser¬ 
vice  in  one  of  our  city  districts  or  in  a  town  that  happens  to  have 
few  foreign  residents,  to  a  crowded  immigrant  quarter  where  he  is 
made  responsible  for  shaping  the  child-protective  activities  or  the 
family  case  work  of  the  neighborhood.  In  addition  to  the  obvious 
duty  of  studying  the  quarter  as  he  finds  it,  he  will  be  confronted 
with  the  further  one  of  trying  to  acquaint  himself  with  the  old 
world  background  of  his  neighbors — not  merely  the  characteristics 
of  their  native  country  as  a  whole,  but  tho: 
inces  and  localities  from  which  they  came. 

382 


e  of  the  different  prov- 


THE  IMMIGRANT  FAMILY 


I.  STUDY  OF  THE  GROUP 

Only  general  suggestions  are  possible  here  as  to  how  such  a 
study  might  be  undertaken.  Following  the  questionnaire  plan 
already  adopted,  a  list  of  queries  has  been  prepared  relating  to 
the  group  background  and  another  list  relating  to  a  family  of  recent 
immigrants.  The  latter  is  given  further  on  (p.  387);  the  former 
follows  here.  I  ts  questions  should  be  understood  to  apply  to  native 
country,  province,  and  town.  From  this,  a  student  of  the  subject 
may  be  able,  after  omitting  those  questions  that  obviously  do  not 
fit  either  the  particular  group  in  mind  or  his  own  individual  needs, 
to  make  a  modified  outline  which  will  serve  as  a  starting  point 
for  his  reading  and  thinking. 

I  Characteristics  of  the  Inhabitants 

1.  Are  they  thrifty  and  industrious?  Are  they  as  a  whole  law  abiding?  What  is 
their  attitude  toward  the  courts?  Does  the  character  of  the  laws  or  the  manner 
of  their  enforcement  explain  any  criminal  tendencies  in  the  community?  Are 
there  any  community  customs  which  are  popularly  recognized  as  substitutes  for 
law?  Where  is  the  line  drawn  between  fellow  citizens  and  strangers? 

2.  Are  the  people  stolid  or  excitable?  Warlike  or  submissive?  Jealous?  Hot- 
tempered?  Given  to  intemperance?  Superstitious?  Suspicious?  Are  there 
any  superstitions  which  in  any  way  affect  their  life  in  this  country?  Are  family 
relations  affectionate?  How  deep  a  hold  has  religion? 

3.  If  there  are  peculiar  and  striking  characteristics  which  are  puzzling  to  Ameri¬ 
cans,  is  there  anything  in  the  history  or  traditions  of  the  people  to  explain  them? 

II  Occupations  and  Recreations 

4.  What  are  the  chief  occupations  of  the  place?  Agriculture?  Manufacturing? 
Fishing?  What  stage  of  development  have  industries  reached?  Are  there 
many  skilled  workmen?  A  large  professional  class?  Is  there  only  one  means  of 
livelihood  in  the  community?  Is  there  any  marked  discrepancy  between  wages 
and  the  cost  of  living? 

5.  Do  the  women  engage  in  wage-earning  occupations?  If  so,  what  is  their  in¬ 
dustrial  status?  Do  they  ordinarily  work  in  the  field?  Do  they  carry  on  home 
manufacturing?  What  is  their  attitude  toward  domestic  service? 

6.  What  are  the  national  songs  and  dances,  the  special  holidays  and  fete  days? 
What  are  the  favorite  recreations  and  sports  of  the  community?  Do  they  de¬ 
velop  the  team  spirit?  Are  games  of  chance  prominent? 

III  Education  and  Culture 

7.  What  opportunities  for  education  are  accessible  to  the  peasant?  What  is  the 
percentage  of  illiteracy  in  the  country?  Among  the  peasants?  Is  education 
secular  or  religious?  Public  or  private?  Is  it  given  in  the  native  language? 

383 


■t 


SOCIAL  DIAGNOSIS 


« 

Is  it  compulsory?  To  what  age?  How  many  weeks  comprise  the  school  year? 
Are  there  trade  schools?  Is  there  any  legally  established  apprenticeship  system 
or  other  system  of  trade  training?  What  training  are  the  women  given,  at  home 
or  at  school,  in  sewing,  knitting,  weaving,  lace-making,  embroidery,  etc.? 

8.  How  do  the  attainments  of  the  educated  class  compare  with  those  of  other 
countries?  Have  there  been  notable  literary  achievements?  What  are  the 
national  arts?  To  what  extent  do  they  form  part  of  the  life  of  all  classes? 

IV  Religion 

9.  Is  there  a  dominant  church,  politically?  Is  it  a  large  factor  in  the  social  and 
community  life  of  the  people?  Does  it  figure  chiefly  in  ceremonials  or  does  it 
influence  the  thought  and  life  of  the  people? 

V  Family  Life  and  Woman’s  Position 

10.  What  is  the  relation  of  parents  and  children?  Does  the  father  have  any  patri¬ 
archal  authority  over  his  family?  Is  the  tie  of  kinship  particularly  strong  or 
weak?  Does  it  extend  beyond  the  immediate  family?  To  relationships  by 
marriage?  Is  intermarriage  of  relatives  common? 

11.  What  is  woman’s  position  in  the  home?  What  is  the  customary  age  at  mar¬ 
riage?  What  amount  of  freedom  do  women  have  before  marriage?  After 
marriage?  How  is  the  marriage  arranged?  What  are  the  dowry  customs? 

12.  What  is  the  general  attitude  toward  irregular  relationships  formed  by  young 
girls?  By  married  women?  Is  betrothal  equivalent  merely  to  engagement,  as 
in  the  United  States,  or  is  it  regarded  as  a  sort  of  trial  marriage? 

VI  Community  Customs 

13.  What  are  the  usual  living  conditions  among  the  peasants  as  regards  housing, 
sanitation,  cleanliness,  etc.?  What  are  the  peculiar  customs  of  dress,  cooking, 
etc.? 

14.  Is  there  a  strong  community  feeling?  If  a  family  is  in  need,  how  is  it  usually 
relieved?  By  relatives,  friends,  public  assistance,  private  organizations?  What 
is  the  popular  attitude  toward  medical  agencies,  toward  institutional  care,  to¬ 
ward  outdoor  relief  and  begging? 

VII  Laws  and  Government 

15.  Is  the  land  held  in  large  estates  or  small  holdings? 

16.  Is  the  country  (or  was  it  until  very  recently)  under  a  liberal  government?  An 
oppressive  government?  Is  taxation  heavy?  To  what  extent  is  the  community 
self-governing?  Is  national  patriotism  strong  in  the  community?  Local  pa¬ 
triotism?  What  are  the  government’s  requirements  regarding  military  service? 

17.  How  progressive  and  competent  is  the  government  in  its  handling  of  sanitary 
and  health  matters? 

18.  What  is  the  nature  of  the  laws  regulating  labor — wages,  hours,  equipment  of 
factories,  etc.?  Are  there  laws  prohibiting  child  labor,  and  how  well  are  they  en¬ 
forced? 


384 


THE  IMMIGRANT  FAMILY 


19.  What  are  the  most  important  legal  regulations  relating  to  the  family?  What 
legal  rights  do  women  have?  Are  both  civil  and  religious  marriage  ceremonies 
required?  Is  divorce  or  separation  permitted?  What  is  the  legal  status  of  the 
illegitimate  child?  What  are  the  laws  of  inheritance  of  wife  and  children?  Of 
trusts  for  minor  children? 

20.  What  governmental  provision  is  there  for  old  age,  unemployment,  sickness, 
accident?  For  dependents,  for  delinquents,  for  defectives? 

VIII  Emigration 

21.  Has  the  emigration  from  this  community  been  a  recent  development?  What 
causes  have  led  to  it — racial,  religious,  economic  (necessity  or  experimentation), 
political?  Has  the  desire  to  escape  military  service  contributed?  Is  exile  used 
as  a  substitute  for  imprisonment? 

22.  Has  emigration  been  unduly  large?  Has  it  drained  the  community  of  the  able- 
bodied?  What  effect  has  emigration  had  on  standards  of  living  and  wages  in 
the  community?  Do  members  of  the  community  receive  much  money  from 
America?  Has  the  emigration  been  mainly  directed  toward  one  destination? 
If  so,  what? 

Answers  to  these  questions  will  not  be  found  in  any  one  place. 
Some  will  be  in  books,  some  can  be  learned  from  people,  and  a 
few  of  the  most  important  of  those  remaining  unanswered  will 
come  gradually  in  the  course  of  one's  daily  work.  No  one  way  of 
proceeding  can  be  urged,  but  if  the  writer  found  herself  suddenly 
responsible  for  social  work  among  a  foreign  group,  she  would  be 
eager  to  get  well  in  mind  the  history  of  their  nation  in  the  last 
hundred  years.  During  that  period  there  have  been  momentous 
political  changes  the  world  over,  and  it  would  be  necessary  to 
understand  those  that  had  most  closely  touched  the  particular 
group  with  which  she  was  dealing.  Sometimes  the  clearest  under¬ 
standing  may  be  had  from  the  “life  and  times"  of  a  great  national 
figure.  No  one  who  has  read  Thayer's  Life  of  Cavour,1  for  ex¬ 
ample,  can  ever  forget  the  strikingly  dissimilar  characteristics  of 
the  natives  of  the  different  Italian  provinces,  or  forget  the  back¬ 
ground  of  Oppression  and  anarchy  that  is  only  half  a  century  away 
from  the  Neapolitan  or  the  Sicilian  of  our  own  day.  Another 
view  of  a  given  foreign  group  may  be  had  from  whatever  native 
poetry  and  legend  best  illustrate  folk  ways.  Some  of  their  modern 
fiction  too  would  be  illuminating,  though  much  of  it  would  be  of  no 

Thayer,  William  Roscoe:  Life  and  Times  of  Cavour.  Boston,  Houghton, 
Mifflin,  and  Company,  19 1 1 . 

25  385 


SOCIAL  DIAGNOSIS 


use  whatever.  Books  of  travel  help,  unless  written  by  men  of 
one  idea,  determined  to  prove  their  point. 

The  history  of  the  coming  to  this  country  of  the  immigrant  group 
which  is  being  studied,  and  the  sum  of  its  achievements  and  failures 
here,  are  often  matters  of  record.  If,  of  the  people  under  consider¬ 
ation,  such  an  admirable  study  has  been  made  as  Miss  Emily  Greene 
Balch  gives  us  in  Our  Slavic  Fellow  Citizens,  this  part  of  the  inquiry 
will  be  made  easy.  :  The  social  settlements  in  America  have  done 
a  great  service  to  tbeir  country  by  interpreting  immigrant  life  in 
its  cities  to  a  preoccupied  public.  From  the  appearance  of  Hull 
House  Maps  and  Papers1  in  1895  to  the  present  time,  they  have 
labored  unceasingly  and  with  rare  discernment  in  this  particular 
field.  The  various  stages  of  Americanization  are  made  clear,  for 
example,  in  a  book  mentioned  earlier — in  Robert  A.  Woods’  Ameri¬ 
cans  in  Process.  J 

Advice  upon  the  right  books  to  read  may  well  be  sought  of  some 
of  the  settlement  leaders,  especially  where  there  is  a  settlement  in 
the  foreign  quarter  which  a  worker  is  studying,  or  where  there  is  one 
in  another  quarter  of  the  city  of  like  character.  Advice  may  be 
sought  of  this  leader  not  only  upon  books  but  upon  the  people  who 
can  help — upon  representative  men  and  women  of  the  colony,  and 
educated  fellow-countrymen  in  the  city.  Some  of  the  latter  hold 
themselves  aloof,  however,  taking  an  unsympathetic  attitude 
toward  the  struggles  of  their  less  sophisticated  compatriots.  The 
case  worker  who  reads  the  language  can  get  many  insights  from 
the  newspapers  and  periodicals  which  are  printed  in  it  in  this 
country. 

II.  STUDY  OF  THE  INDIVIDUAL 

As  already  said,  our  questions  will  not  be  fully  answered  by 
any  or  all  of  these  means.  It  should  also  be  repeated  that  in¬ 
dividuals  and  families  cannot  be  treated  merely  as  recent  immi¬ 
grants  exhibiting  certain  racial  and  national  characteristics.  They 
are  human  beings  first  of  all.-  Even  the  detailed  questions  which 
follow,  outlining  not  only  their  early  history  and  their  migration 
to  this  country  but  the  period  of  attempted  adjustment  here,  do 
not  necessarily  bear  upon  the  most  important  part  of  the  client’s 
story  in  every  case. 

1  Hull  House  Maps  and  Papers.  New  York,  T.  Y.  Crowell  and  Company,  1895. 

386 


the  immigrant  family 


IMMIGRANT  FAMILY  QUESTIONNAIRE1 

firmed'by/pubHc1  records  at  ^  anSWer  *°  the  qUeSti°n  may  be  found  in-  or 

general  '* 

necessary  to  give  them  special  emphasis  instances,  when  it  has  seemed 

I  Parents  and  Early  Home  in  Old  Country 

1.  In  what  country,  province,  and  town  were  the  husband  and  wife  born  and 
brought  up?  Was  birthplace  (or  early  home,  if  different)  in  highland  or  lowland 

town  or  city?3  2  S6aP°rt?  'S0'ated  fr°m  f°re‘gn  influences?  ln  country, 

2.  Was  the  family  home  comfortable?  How  many  rooms  were  there?  Of  what 
m  general,  did  the  family's  food  consist?  Was  it  meager  in  quantity  or  variety? 

Was  it  limited  by  custom  or  by  economic  conditions?  Was  the  income  of  the 
family  sufficient  for  family  needs? 

3.  Did  the  father  work  in  the  field,  factory,  shop,  or  at  a  profession?  Did  he  work 

on  s  are  or  by  the  day?  Did  he  hold  any  government  position?  Did  the  mother 
work  as  well?  At  what?  motner 

4.  Did  the  family  belong  to  a  dominant  or  a  subject  race?  What  was  the  standing 
of  the  family  ,n  the  community?  Was  the  standard  of  living  in  any  respect 
above  or  be low  the  general  level?  If  so,  how  and  why?  Did  the  father  own 

property?  What  was  its  nature  and  value?  Has  this  property  deteriorated 
in  value?  Has  it  been  sold? 

Lhu  thp  fw!]y  a  UniT  0ne?  Had  the  father  patriarchal  authority  over  the 
children?  What  was  the  attitude  of  the  family  toward  the  mother?  Were 

involved?1' WhT  StTng  f"  ti:e.h0me?  |S  any  hiSt0ry  of  reliSious  Persecution 
it  I°ved?  W3S  y  atWUde  t0Ward  the  government  under  which 

6.  Was  there  any  family  history  of  insanity,  feeble-mindedness,  tuberculosis  deaf 
mutism,  eye  disease,  goitre,  or  syphilis? 

7.  Had  either  parent,  or  any  members  of  their  families,  a  criminal  record?*  A 
record  of  unusual  immorality? 

3.  How  many  brothers  and  sisters  have  the  husband  and  wife  had?  How  many 
are  now  in  this  country,  how  many  abroad?  What  is  name,  address,  age  occu¬ 
pation,  social  and  economic  status  of  each?  Influence  with  these  clients  of  each? 

!•  If  parents  or  brothers  or  sisters  have  died,  what  was  age  and  cause  of  death  in 
each  case?* 

ts  adults  iS  f0,r  ?  family  in  which  the  parents  came  to  this  country 

...  .  •  ’  ,  manage.  If  they  came  as  children  or  young  people  some  of  the 
luestions  and  their  grouping  would  have  to  be  modified;  the  questionnaire  might 

ng  generatiom  regarded  aS  appiymg  ln  Part  to  the  parents  belonging  to  the  precfd- 


387 


SOCIAL  DIAGNOSIS 


II  [Individual  History  prior  to  Marriage 

10.  What  type  of  school — public  or  private,  church  or  secular — did  the  two  heads 
of  the  present  family  attend?  Did  they  learn  to  read  and  write  their  own 
language  or  any  other?  At  what  age  did  each  leave  school? 

1 1 .  What  was  the  age  of  each  at  beginning  work?  Was  it  for  the  father,  or  was 
he  or  she  apprenticed,  or  put  to  work  for  a  regular  wage?  What  was  the  nature 
of  the  work?  Was  it  too  hard  for  his  or  her  years?  Did  the  man  ever  serve  in 
the  army  or  navy?*  How  long?*  Was  service  compulsory? 

12.  When  did  each  first  break  away  from  home  ties,  and  why? 

13.  Had  either  been  married  before  the  present  marriage?  If  so,  what  were  the 
circumstances,  time,  and  place?*  Did  the  former  wife  or  husband  die?  If  so, 
when  and  where?*  Under  what  circumstances?  Did  he  or  she  leave  any  prop¬ 
erty*  or  insurance?  If  still  living,  has  a  divorce  been  secured?  If  so,  when, 
where,  and  for  what  cause?* 

14.  Was  the  earlier  marriage  a  happy  one?  What  period  elapsed  before  remar¬ 
riage?  Was  remarriage  for  economic  reasons?  Were  there  any  illegal  relation¬ 
ships  before  the  present  marriage? 

III  Marriage  and  Family  Life 

1 5.  Are  husband  and  wife  from  the  same  community  and  class?  Are  they  related? 
In  what  degree?  Are  they  of  different  races,  religions,  or  nationalities?  Of 
widely  different  ages? 

16.  What  was  the  period  of  acquaintance  before  marriage?  Was  the  marriage 
negotiated  by  the  respective  families?  If  so,  what  were  the  guiding  principles 
of  the  choice? 

17.  When  and  where  did  marriage  take  place?*  Was  there  both  civil  and  church 
ceremony?  Have  they  a  certificate?  Who  were  the  witnesses?* 

18.  When  (exact  date)  and  where  was  each  child  born?*  Christened?  Who  were 
its  sponsors? 

19.  What  is  the  relation  of  parents  and  children?  Does  the  father  have  any  pa¬ 
triarchal  authority  over  his  family?  What  is  the  mother’s  position  in  the  home? 
Is  the  tie  of  kinship  particularly  strong  or  is  it  weak?  Does  the  tie  extend  be¬ 
yond  the  immediate  family? 

20.  Has  the  marriage  been  a  happy  one?  If  not,  did  the  trouble  begin  before  emi¬ 
gration?  When  and  how?  Was  there  any  evidence  of  unfaithfulness? 

21.  Did  the  home,  after  marriage,  compare  favorably  with  those  that  the  husband 
and  wife  had  known  before?  Did  the  husband  support  the  family  to  the  best  of 
his  ability? 

IV  Circumstances  Pertaining  to  Emigration 

22.  Had  there  been  any  change  in  the  family’s  circumstances  which  made  emi¬ 
gration  desirable?  Did  they  come  to  earn  the  necessities  or  the  comforts  of  life, 
or  was  it  to  accumulate  savings  to  take  home?  Was  it  to  escape  justice?  To 
avoid  military  service?  Was  it  because  of  racial  or  religious  persecution?  Be¬ 
cause  of  domestic  difficulties  or  infelicities? 

388 


THE  IMMIGRANT  FAMILY 


23.  Did  the  husband  have  regular  work  at  the  time  of  emigration?  What  was  he 
doing  at  that  time? 

24.  Had  relatives  or  friends  preceded  them?  Did  the  impetus  come  from  a  steam¬ 
ship  agent,  or  from  printed  matter  sent  out  by  steamship  companies?  Was  work 
promised  by  an  employment  agency  or  a  steamship  company? 

25.  How  were  the  necessary  funds  secured?  From  savings,  from  selling  or  mort¬ 
gaging  property,  by  borrowing  from  relatives  or  friends,  from  a  steamship  agent, 
from  a  banker?  For  how  long  a  period  were  they  planning  and  saving  for  the 
journey?  What  was  the  destination  on  embarking?  Why  had  the  emigrant 
chosen  that  particular  town  or  city? 

26.  If  money  was  borrowed,  how  much,  and  what  were  the  terms  of  payment? 
What  household  belongings,  if  any,  did  they  bring  with  them? 

27.  Did  the  husband  leave  his  family  behind?  If  so,  what  provision  did  he  make 
for  their  support?  Did  he  send  money?  Did  relatives  care  for  them?  Did  they 
have  income  from  property?  Did  the  wife  work?  How  long  before  the  family 
joined  him?  How  was  the  money  secured? 

28.  From  what  port  did  he  (and  his  family)  embark?*  Name  of  steamship?* 
Did  he  follow  route  ordinarily  taken  from  his  town?  If  not,  why? 

29.  What  was  the  port  of  entry,  date  of  landing  (and  other  items  on  passport)?* 
Had  husband  (or  family)  received  instructions  regarding  answers  at  port? 
What,  why,  from  whom?  Was  he  (or  were  they)  detained?*  Why,  how  long, 
how  released?*  Were  there  any  reasons  why  any  member  of  the  family  could 
not  be  admitted?*  What  was  done?*  Who  befriended  and  who  took  advantage 
of  the  family?  To  whom  were  they  assigned?*  Did  they  go  first  to  a  relative  or 
friend?  What  address? 

V  Industrial  Adjustment  in  This  Country 

30.  How  much  money  did  the  husband  have  on  landing?  Was  it  his  own?  Did  it 
last  until  he  was  able  to  earn  his  way?  If  not,  how  did  he  manage? 

31.  What  work  did  he  expect  to  do  in  this  country,  and  why?  If  he  had  been 
promised  a  job  before  coming,  what  was  it,  and  by  whom  promised?  Did  he  get 
it?  How  long  before  he  went  to  work?  How  did  he  get  his  first  job?  What 
was  the  nature  of  work?  Was  he  fitted  for  it  by  previous  training  or  experience? 
What  were  his  wages? 

32.  How  did  this  occupation  compare  with  work  formerly  done  by  him  in  the  old 
country  as  regards  skill  or  strength,  healthfulness,  remuneration,  hours,  and 
chances  for  future  development?  Was  he  handicapped  by  not  speaking  English? 
Was  he  at  an  advantage  or  disadvantage  over  Americans  in  the  same  industry? 
Were  others  of  his  countrymen  employed  with  or  over  him?  How  long  did  he 
keep  this  job  and  what  were  his  reasons  for  leaving  it?  Was  his  next  job  an 
advance  over  his  first? 

33.  If  work  was  of  a  different  nature  from  that  to  which  he  was  accustomed,  what 
effort  was  made  to  procure  work  of  his  own  kind?  Has  he  ever  procured  such  work 
since?  When  and  how?  What  were  the  difficulties  in  keeping  it? 

389 


SOCIAL  DIAGNOSIS 


34.  Was  he  a  member  of  a  trade  union  in  the  old  country,  and  if  so,  why  has  he  not 
joined  one  in  America?  Is  he  eligible  for  membership  here? 

35.  How  many  places  has  he  had  in  this  country?  Has  he  been  frequently  out  of 
work?  Because  of  illness,  hard  times,  lack  of  knowledge  of  English,  or  for  what 
other  cause?  How  long  idle?  How  did  he  secure  work  again?  Has  his  work 
been  seasonal?  Irregular?  Either  of  these  by  his  own  choice?  Has  it  been 
casual?  Regular?  What  changes  in  nature  of  work?  Has  his  work  necessi¬ 
tated  changes  in  habits  of  living  and  in  his  recreations? 

36.  Has  he  ever  been  exploited  by  any  employment  agency,  broker,  padrone? 
Compelled  to  pay  lump  sums  to  secure  a  job,  or  to  share  earnings  with  foremen  or 
others?  Sent  to  jobs  which  proved  to  be  non-existent?  Discharged  after  brief 
periods  of  employment  to  make  way  for  new  employes?  Has  there  been  exploi¬ 
tation  of  this  family  and  of  the  colony  of  which  it  is  a  part  by  a  ring  composed  of 
the  employment  agent,  a  banker,  grocer,  steamship  agent,  or  the  like? 

37.  If  debts  were  contracted,  either  before  or  after  arrival,  did  he  pay  them  off? 
How  long  did  this  take?  Did  he  or  does  he  send  money  to  the  old  country?  In 
payment  of  debts,  as  an  investment,  or  to  support  members  of  his  family?  How 
much?  How  frequently?  Through  whom? 

38.  Has  he  ever  returned  to  the  old  country?  If  so,  how  was  the  money  procured? 

39.  Has  the  wife  ever  worked  outside  the  home?  At  what?  Has  she  done  home 
work?  Of  what  nature?  Has  she  worked  whenever  she  could  find  work  to  do, 
or  has  she  resorted  to  such  work  only  in  times  of  special  emergency?  What  pro¬ 
vision  was  made  for  the  children  during  her  absence? 

40.  If  there  are  children  of  working  age,  at  what  age  did  they  leave  school,  and 
what  has  been  the  industrial  history  of  each?  Have  they  frequently  shifted 
from  one  job  to  another?  Have  they  been  shunted  into  “dead-end"  occupa¬ 
tions?  Have  they  shown  any  ambition?  Any  special  abilities? 

VI  Social  Adjustment  in  This  Country 

41.  Has  the  family  lived  here  in  a  colony  (or  colonies)  of  its  own  nationality?  Is 
this  colony  large  enough  to  have  business  and  interests  of  its  own  which  are  inde¬ 
pendent  of  the  rest  of  the  community?  Does  the  colony  maintain  a  newspaper 
(daily  or  weekly)  in  its  own  language?  What  characteristics  does  the  colony 
ascribe  to  Americans  in  general  and  to  American  women  in  particular?  Has 
there  been  any  friction  between  this  colony  and  the  rest  of  the  community? 
What  contact  has  there  been,  by  the  man  and  the  woman,  with  Americans  or 
with  those  of  any  nationality  other  than  their  own? 

42.  In  what  way  has  the  family’s  home  life  in  this  country  differed  from  that  in 
Europe?  What  customs  had  to  be  changed? 

43.  Has  there  been  evidenced  a  persistent  clinging  to  the  old,  or  a  willingness  to 
try  the  new?  What  is  the  general  community  feeling  in  this  respect?  Has  this 
family  been  particularly  slow  in  making  this  adjustment? 

44.  How  far  have  the  husband  and  wife  progressed  in  learning  the  English  language? 
Has  either  attended  night  school? 


390 


THE  IMMIGRANT  FAMILY 

45.  Has  it  been  the  plan  of  the  family  to  return  to  Europe  for  final  settlement  or  to 
remain  permanently  in  this  country? 

46.  What  steps,  if  any,  has  the  husband  taken  toward  naturalization?*  What 
preparation,  if  any,  has  he  had  for  naturalization?  If  he  has  taken  no  steps, 
what  is  his  reason?  If  he  has  been  denied  his  certificate  of  naturalization,  on 
what  ground  did  the  court  base  its  action?* 

47.  Has  he  shown  any  interest  in  politics?  Frequented  any  club  where  public 
matters  are  discussed?  Shown  enthusiasm  for  democratic  ideals? 

48.  Have  there  been  changes  in  standard  of  living,  in  food,  in  number  of  rooms, 
etc.,  during  the  period  of  residence  in  this  country?  What  and  why?  Has  this 
change  been  for  the  better  or  for  the  worse?  If  the  mother  has  been  accus¬ 
tomed  to  do  any  work  for  pay,  what  effect  has  it  had  upon  the  family  standards? 

49.  Have  their  church  affiliations  been  vital  or  merely  nominal?  Has  the  hold  of 
the  church  on  them  been  strengthened  or  weakened  by  immigration?  Have  they 
contributed  regularly  to  the  support  of  the  church? 

50.  Have  the  children  attended  public*  or  parochial  school?  Or  both?  Have  their 
teachers  been  of  foreign  birth?  Have  they  been  taught  chiefly  or  entirely  in  a 
foreign  language?  Have  they  mingled  with  native  American  children  or  chil¬ 
dren  of  other  nationalities?  Has  their  school  progress  been  normal  for  their 
ages?  If  not,  has  there  been  anything  in  the  family  history  or  home  life  to  ac¬ 
count  for  the  retardation?  Has  it  been  due  to  lack  of  adjustment  to  American 
conditions?  Have  the  children  been  truants?  Have  the  parents  kept  them  out 
of  school  to  work? 

51.  What  use,  if  any,  have  the  children  made  of  night  schools,  special  classes  or 
clubs,  the  libraries? 

52.  Have  the  children  grown  away  from  parental  influence?  In  what  way  was 
this  first  noticed?  How  early  did  estrangement  begin?  Has  it  reached  a  serious 
stage?  Has  the  tendency  of  some  teachers  and  social  workers  to  disregard  the 
parents  and  deal  with  the  family  only  through  the  children  been  a  factor  in 
breaking  down  the  children's  respect  for  their  parents? 

53.  Have  the  children  introduced  any  changes  into  the  family  customs  and  routine? 
What?  Are  they  contemptuous  of  all  old  world  customs,  without  discrimina¬ 
tion?  Are  they  extravagant  in  matters  of  dress  and  amusement?  Is  there  un¬ 
necessary  friction  or  is  the  family  willing  to  make  the  adjustment?  Does  the 
family  appreciate  the  danger? 

54.  What  forms  of  amusement  have  the  family  been  accustomed  to  enjoy  together? 
What  forms  separately?  How  do  the  various  members  of  the  family  spend  their 
Sundays  and  evenings? 

55.  Has  there  been  any  deterioration  in  character,  or  in  moral  or  physical  stamina, 
in  any  member  of  the  family?  Have  any  members  suffered  from  serious  or  pro¬ 
longed  illnesses? 

56.  If  any  of  the  children  have  died,  when  and  from  what  causes?* 

391 


SOCIAL  DIAGNOSIS 


57.  Have  there  been  emergencies  in  which  the  family  has  sought  or  accepted  aid? 
Have  relatives  or  friends  assisted  at  such  times?  How  long  after  arrival  in  Amer¬ 
ica  was  first  application  for  relief  (if  any)  made  to  a  public*  or  private  agency? 
What  was  the  occasion?  What  were  the  results?  What  has  been  the  effect  on 
the  family,  on  relatives  and  friends?  Is  there  evidence  of  growing  dependence? 

VII  Housing  at  Present 

58.  How  long  has  the  family  lived  in  its  present  home?  How  does  home  compare 
with  previous  ones  in  this  country  in  respect  to  neighborhood,  number  of  rooms, 
lighting,  ventilation,  sanitation,  and  furnishings?  Is  the  landlord  one  of  their 
own  nationality?  Is  he  a  fellow  townsman?  Does  he  live  in  the  same  house? 
Is  he  paying  for  the  house  and  therefore  unwilling  to  put  money  into  repairs? 
Do  these  facts  affect  the  rental?  How  does  rent  compare  with  that  for  similar 
accommodations  in  other  parts  of  the  city?  What  determined  the  family  in  its 
choice  of  this  location — nearness  to  work,  presence  of  compatriots,  any  other 
factors? 

59.  How  many  persons  sleep  in  a  single  room?  Is  the  number  a  menace  to  the 
physical  or  moral  welfare  of  the  family?  How  many  rooms  are  there  for  general 
use  (not  sleeping  rooms)?  How  do  these  conditions  compare  with  those  in  the 
old  world,  and  with  their  previous  quarters  in  this  country? 

VIII  Lodgers 

60.  Are  there  any  lodgers?  How  many?  Men  or  women?  On  what  terms  are 
they  kept?  Does  housewife  cook  their  food?  Does  food  left  over  go  to  the 
family?  Do  they  share  a  room  with  any  members  of  the  family?  Are  they 
relatives,  fellow  townsmen?  Have  they  but  recently  arrived  in  America? 

61.  Is  the  presence  of  lodgers  rendered  necessary  by  the  family  budget?  Are  they 
kept  to  swell  a  savings  account,  or  to  make  payments  on  property  possible?  Are 
they  kept  from  motives  of  friendship?  Are  the  lodgers  kept  only  occasionally, 
or  is  it  a  custom?  Is  the  family  anxious  to  dispense  with  them? 

62.  Are  the  lodgers  also  boarders?  On  what  terms?  Are  they  an  added  burden  to 
the  family  when  out  of  work?  Does  the  family  ever  borrow  money  of  the  lodg¬ 
ers?  Are  their  habits  or  physical  condition  such  as  to  be  a  menace  to  the  family 
in  any  way? 

IX  Health 

63.  What  is  the  physical  and  mental  condition  of  each  member  of  the  family? 
His  fitness  for  his  work?  Is  a  cause  of  ill  health  to  be  found  in  housing  or  living 
conditions,  in  hours  or  conditions  of  .work,  or  in  lack  of  adjustment  to  conditions 
of  life  in  America? 

64.  What  is  the  attitude  of  the  heads  of  the  family  toward  medical  agencies,  dis¬ 
pensaries,  hospitals?  Is  this  attitude,  if  unfriendly,  accounted  for  by  exploita¬ 
tion  in  this  country  or  abroad,  at  the  hands  of  medical  quacks  or  fake  institu¬ 
tions?  Is  it  an  attitude  characteristic  of  the  people  in  the  family’s  home  town  in 
the  old  country? 


392 


THE  IMMIGRANT  FAMILY 


X  Occupations1 

65.  What  is  the  present  occupation  of  each  member  of  the  family?  Hours  of  work, 
habitual  and  overtime? 

XI  Needs  and  Resources1 

66.  If  the  family  is  unable  to  speak  English,  who  is  the  person  who  has  been  acting  as 
interpreter?  Are  his  general  intelligence,  his  knowledge  of  English  and  of  the  foreign 
language  he  claims  to  know,  and  his  disinterestedness  such  as  to  make  the  informa¬ 
tion  about  needs,  resources,  and  other  matters  obtained  through  him  quite  reliable? 

67.  If  the  family  is  in  need,  what  circumstances  are  responsible?  How  does  the 
present  emergency,  if  there  is  one,  differ  from  any  that  have  previously  arisen? 
Have  relatives,  friends,  fellow  townsmen  assisted?  Is  their  aid  less  than  on  pre¬ 
vious  occasions?  Why? 

68.  Does  either  the  husband  or  wife  belong  to  any  lodge  or  benefit  society?  If  so, 
what  are  the  dues?  If  they  do  not,  what  is  their  reason?  If  they  have  dropped 
out,  when  was  it  and  why?  What  are  the  chances  of  reinstatement?  Who  are 
the  officers,  the  doctor?  Are  some  of  the  members  fellow  townsmen?  Is  it  a 
religious  organization? 

69.  Has  the  organization  aided  them  by  the  payment  of  sickness  or  of  death  benefits? 
When?  To  what  extent?  What  are  the  rulings  as  to  this?  Do  they  ever  make  volun¬ 
tary  collections  in  addition  to  the  regular  aid?  Through  whom  is  the  money  paid? 
Do  they  carry  members  on  their  books  who  are  temporarily  unable  to  pay  dues? 

70.  What  are  the  death  benefits  of  the  organization?  Is  it  a  fixed  amount,  or  pro¬ 
portional  to  membership?  How  long  after  death  is  the  amount  paid  to  bene¬ 
ficiaries?  Is  the  undertaker  paid  first?  Does  the  society  itself  make  the  ar¬ 
rangements  with  the  undertaker? 

71.  Has  the  family  within  recent  years  received  any  inheritance,*  damages,*  or  in¬ 
surance  money?  Has  it,  or  did  it  recently  have,  savings?  Does  it,  or  did  it 
recently,  own  any  property?* 

72.  What  prospect  does  there  seem  to  be  that  this  family  will  retain  or  regain  eco¬ 
nomic  independence?  That  they  will  make  a  satisfactory  social  adjustment  in  this 
country?  If  these  prospects  are  slight,  would  it  be  possible  and  desirable  to 
deport  them?  Are  they  deportable  on  any  of  the  grounds  specified  in  the  Im¬ 
migration  Law?2— for  example,  as  mentally  deficient,  insane,  or  epileptic;  as 

1  For  Income  and  Outgo  and  further  questions  relating  to  Occupations,  see  ques¬ 
tionnaire  regarding  Any  Family,  questions  26  and  27  and  21  to  25. 

It  should  be  borne  in  mind  that  an  alien,  to  be  deportable,  must  (with  certain 
exceptions)  have  been  “at  the  time  of  entry  .  .  .  a  member  of  one  or  more  of 

the  classes  excluded  by  law,”  or  must  have  become  “within  five  years  after  entry 

•  .  .  a  public  charge  from  causes  not  affirmatively  shown  to  have  arisen  subse¬ 
quent  to  landing.  The  Immigration  Law  of  1917,  especially  in  sections  3  and  19, 
contains  a  number  of  important  departures  from  previous  laws — as,  for  example, 
in  regard  to  the  period  after  landing  during  which  deportation  is  possible;  and  con¬ 
sultation  with  immigration  authorities  as  to  its  interpretation  and  the  conditions 
o  its  enforcement  will  be  advisable  for  the  layman  who  is  considering  the  possi¬ 
bility  of  securing  action  under  it. 


393 


SOCIAL  DIAGNOSIS 


paupers,  beggars,  or  vagrants;  as  chronic  alcoholics;  as  tuberculous  or  afflicted 
with  any  loathsome  or  dangerous  contagious  disease;  as  criminals;  as  prostitutes 
or  persons  who  profit  by  prostitution;  as  anarchists  or  persons  who  advocate  or 
teach  the  unlawful  destruction  of  property;  as  contract  laborers;  as  illiterates? 
If  they  are  not  deportable,  would  it  be  possible  to  arrange  for  their  return  to  the 
old  country  by  consular  ticket?  Are  there  relatives  there  who  would  assume 
responsibility? 


CHAPTER  XXII 


DESERTION  AND  WIDOWHOOD 

THE  situation  of  the  mother  whose  children  have  been 
deserted  by  their  father  and  that  of  the  widowed  mother 
with  children  present  some  superficial  resemblances.  An 
early  stage  in  the  development  of  social  treatment— one  domi¬ 
nated  by  emergencies  and  by  surface  symptoms— usually  leaves 
the  two  situations  undifferentiated.  That  they  present  different 
problems  is  shown  by  the  two  questionnaires  which  follow. 

State  laws  relating  to  the  apprehension  and  punishment  of  de¬ 
serters  are  so  varied  that  no  questions  are  included  with  regard 
to  extradition,  trial,  suspension  of  sentence,  probation,  reimburse¬ 
ment  of  family  during  imprisonment,  etc.  It  is  assumed  here  that 
the  social  worker  knows  the  state  law  or  city  ordinance  bearing 
upon  desertion  and  intends  to  confer  with  the  public  officials  or 
private  agencies  most  interested  in  its  enforcement. 

For  re-enforcement  of  the  position  frequently  taken  in  these 
pages  that  single  disabilities  cannot  be  treated  as  ultimate  causes, 
and  that  they  cannot  be  understood  even  in  one  case  without 
reference  to  the  factors  behind  and  those  entering  into  their  mani¬ 
festations,  attention  may  be  called  to  the  desertion  case  summar¬ 
ized  on  page  140.  Even  the  finding  of  a  deserter,  which  is  the  first 
step  in  his  treatment,  of  course,  can  be  expedited  by  the  attempt, 
from  such  data  as  are  at  hand,  to  understand  him. 

DESERTED  FAMILY  QUESTIONNAIRE 

This  is  not  a  schedule  to  be  filled  out  nor  a  set  of  queries  to  be  answered  by  a 
social  agency  s  client  or  clients.  For  an  explanation  of  the  purpose  of  these  ques¬ 
tionnaires  see  p.  373  sq. 

A  star  (' )  indicates  that  the  answer  to  the  question  may  be  found  in,  or  con¬ 
firmed  by,  public  records. 

The  questionnaire  regarding  Any  Family  (p.  378)  precedes  this  one.  Its  more 
general  questions  are  repeated  here  only  in  rare  instances,  when  it  has  seemed  neces¬ 
sary  to  give  them  special  emphasis. 

1.  What  steps,  if  any,  have  been  taken  to  make  sure  that  the  husband  is  not  in  the 
immediate  neighborhood  and  in  communication  with  his  family?  That  he  is 
not  income  hospital  unidentified?  That  he  has  not  been  arrested  and  sent  to 

395 


SOCIAL  DIAGNOSIS 


the  house  of  correction  or  some  other  institution?  Or  that  he  has  not  gone  away 
to  seek  work  with  the  knowledge  and  approval  of  his  wife?  What  is  the  wife’s 
reputation  for  trustworthiness? 

2.  If  it  is  clear  that  the  desertion  is  genuine,  what  steps  have  been  taken  to  trace 
him?  Has  his  picture  been  obtained  for  purposes  of  identification?  Have  out- 
of-town  and  in-town  relatives  and  friends  been  consulted?  Or  his  last  foreman, 
his  fellow  workmen,  etc.,  or  his  neighborhood  cronies,  and  the  keeper  of  the 
saloon,  if  he  frequented  one?  Or  any  benefit  societies  and  trade  union  to  which 
he  may  have  belonged?  Have  army  and  navy  enlistments  been  consulted,  or  the 
police? 

I  Circumstances  of  Present  Desertion 

3.  When  did  the  husband  last  desert?  What  steps  on  her  own  initiative  has  his 
wife  taken  to  find  him?  What  steps  with  the  help  of  others,  and  of  whom? 

4.  What  is  the  wife’s  statement  as  to  the  immediate  cause  of  his  departure?  As  to 
her  knowledge  or  inference  with  regard  to  his  intention?  As  to  his  present 
whereabouts? 

5.  Has  he  ever  been  in  other  cities?  Which?  Has  he  ever  expressed  a  desire  to 
visit  any  special  place?  Is  it  likely  that  forwarding  of  mail  to  him  has  been 
arranged  for  at  the  post  office?*  Does  he  speak  so  little  English  that  he  would 
probably  be  found  in  the  foreign  colony  in  whatever  city  he  went  to?  What 
languages  does  he  speak? 

6.  If  husband’s  whereabouts  is  known,  what  is  his  statement  of  the  cause  of  his 
desertion? 

7.  What  do  relatives  on  each  side,  friends,  fellow  employes,  and  other  references 
give  as  probable  causes  of  his  desertion?  What  bias  have  these  different  wit¬ 
nesses? 

8.  Was  wife  pregnant  at  time  of  desertion? 

9.  What  was  husband’s  employment  at  time  of  desertion?  If  none,  causes  of  un¬ 
employment?  How  long  had  he  been  out  of  work? 

10.  Have  any  facts  that  explain  the  desertion  come  to  light?  Was  there  a  special 
burden  of  debt,  including  installment  purchases?  Or  was  husband  in  danger  of 
arrest  for  some  dishonesty?  Are  any  earlier  criminal  acts  on  record?*  Is  there 
any  evidence  that  he  is  mentally  abnormal  or  nervously  unstable? 

1 1.  Did  he  take  money  (if  so,  how  much)  or  clothing  with  him?  Did  he  have  sav¬ 
ings?  Where  did  he  get  the  money  to  go  with?  Did  he  leave  any  personal  or 
real  property  or  money  in  bank?  Has  the  wife  any  property? 

12.  Since  he  left,  has  he  sent  money  or  other  supplies  to  his  family?  How  much? 
Date  of  last  remittance?  Date  and  postmark  of  last  letter? 

13.  If  his  whereabouts  is  known,  is  he  at  work?  What  are  his  earnings?  Is  he 
living  with  another  woman? 

14.  Has  the  wife  sworn  out  a  warrant  for  his  arrest?*  (In  some  places  a  warrant 
cannot  be  had  until  the  husband’s  whereabouts  is  known.)  What  is  her  attitude 

396 


THE  DESERTED  FAMILY 


toward  jail  sentence,  probation,  separate  support,  or  reconciliation,  and  is  this 
attitude  likely  to  be  a  stable  one?  What  other  plans  has  she  for  the  immediate 
future? 

II  Past  Desertions 

15.  How  many  times  has  husband  deserted  his  present  wife  before?  How  long  after 
marriage  did  he  first  desert?  Length  of  each  period  of  desertion?  Intervals 
between  desertions?  What  events  led  up  to  each?  Is  there  any  long  interval 
between  births  of  the  children  next  to  each  other  in  age  that  may  be  due  to  pro¬ 
longed  separation  of  parents? 

16.  Where  did  he  go  on  previous  desertions?  How  did  he  go-by  freight,  tramping, 
or  paying  his  way?  Did  he  get  work  elsewhere?  Did  he  send  money  home? 
How  much? 

17.  In  each  desertion,  what  action,  if  any,  was  taken  by  the  wife,  by  the  courts,* 
by  public*  or  private  charity,  and  with  what  results?  How  was  the  wife  sup¬ 
ported  in  his  absence?  What  effort  was  made  to  develop  his  sense  of  responsi¬ 
bility  for  his  family  after  his  return? 

18.  Have  there  been  any  arrests  for  non-support?*  If  so,  with  what  results?* 

19.  What  were  the  circumstances  of  each  return?  When  persuaded  to  take  her 
husband  back,  what  outside  influences,  if  any,  led  to  the  wife’s  action? 

IH  The  Husband’s  Early  Life 

20.  What  were  the  general  conditions  of  the  husband’s  early  home  life?  What 
was  his  home  training?  Was  he  indulged  or  unduly  repressed?  Did  his  father 
and  mother  fulfill  their  responsibilities?  Did  either  show  evidence  of  physical 
or  mental  defect?  Did  his  father  ever  desert  or  fail  to  provide  for  his  family? 

21.  Did  the  husband  have  any  institutional  training  as  a  boy?  Of  what  nature? 
For  how  long? 

22.  Did  he  earn  before  leaving  school,  either  by  selling  papers,  doing  errands,  or 
otherwise?  Any  truancy  or  other  signs  of  a  roving  disposition  during  school  life? 

23.  What  was  his  age  and  in  what  grade  was  he  when  he  left  school?  Did  he  go 
to  work  immediately  and  work  regularly?  If  not,  was  it  because  he  preferred  to 
loaf?  How  often  did  these  loafing  periods  come  and  how  long  did  they  last? 
Did  he  show  a  tendency  to  wander  from  home  then? 

24.  What  were  his  amusements  in  childhood  and  youth? 

25.  What  employment  or  employments  did  he  choose?  What  opportunity  for  de¬ 
velopment  did  they  offer? 

26.  Did  he,  before  marriage,  turn  over  his  wages  to  the  family? 

27.  When  did  he  leave  his  parents’  home?  Why? 

28.  Did  he  ever  serve  in  army  or  navy?* 

29.  Was  he  ever  married  before?  Was  it  a  legal  marriage?*  Was  he  then  a  de¬ 
serter  or  arrested  for  non-support?*  Has  he  children  by  another  marriage? 
What  are  the  relations  between  these  children  and  their  stepmother? 

397 


SOCIAL  DIAGNOSIS 


IV  The  Wife’s  Early  Life 

30.  What  were  the  wife’s  early  home  life,  education,  and  training?  (For  details 
that  apply,  see  The  Husband’s  Early  Life,  20  to  29.)  On  what  terms  is  she  now 
with  her  own  people? 

31.  Did  she  have  any  training  at  home  or  school  to  prepare  her  for  making  a  home? 

32.  Did  she  work  before  marriage?  If  so,  at  what  and  under  what  conditions? 

33.  Had  she  been  previously  married?*  If  so,  what  children  had  she  by  that 
marriage  and  what  have  been  the  relations  between  them  and  their  stepfather? 

V  Their  Married  Life 

34.  How  did  husband  and  wife  meet?  What  was  age  of  each  at  present  marriage?* 

35.  When  (exact  date),  where,  and  under  what  circumstances  were  couple  married?* 

36.  Is  marriage  legal?  If  married  by  religious  ceremony  in  the  old  country,  is  it 
legal  here?  Has  either  a  husband  or  wife  living  from  whom  no  divorce  has  been 
obtained?  (In  the  treatment  of  desertion  cases  it  is  especially  important  to 
have  some  legal  proof  of  the  marriage.) 

37.  Did  marriage  take  place  because  wife  was  pregnant?  If  so,  was  marriage 
forced  upon  husband?  Were  there  any  other  unusual  circumstances? 

38.  At  time  of  marriage,  did  either  husband  or  wife  have  any  money  saved?  How 
was  it  spent?  Did  they  buy  furniture  on  the  installment  plan?  What  was  their 
income  when  first  married?  Rent?  Character  of  neighborhood  in  which  they 
began  married  life?  Was  the  home  better  or  worse  than  either  had  been  accus¬ 
tomed  to  before  marriage? 

39.  Have  they  ever  lived  in  furnished  rooms? 

40.  Have  they  ever  lived  with  their  relatives?  Have  any  of  their  relatives  ever 
lived  with  them?  Have  they  interfered  in  the  home?  What  are  the  character¬ 
istics  of  the  relatives  who  have  been  most  closely  associated  with  the  family? 

41.  Have  the  family  taken  lodgers  or  have  any  other  outsiders  lived  with  them? 
Men  or  women?  What  have  been  their  relations  with  the  husband?  With  the 
wife? 

42.  If  foreign  born,  did  man  precede  his  family  in  coming  to  this  country?  How 
long?  Have  differences  in  degree  of  Americanization  influenced  the  home  life? 
(See  Immigrant  Family  Questionnaire,  p.  387.) 

43.  What  striking  differences,  if  any,  between  husband  and  wife  in  age,  race,  na¬ 
tionality,  religion,  education,  or  personal  habits?  Have  these  differences  led  to 
disagreements  and  family  dissension?. 

44.  What  was  husband’s  occupation  when  living  with  his  family,  and  his  average 
wage?  Was  it  enough  to  maintain  a  decent  standard  of  living?  How  did  his 
wage  in  the  last  position  held  compare  with  his  maximum  wage?  If  lower,  what 
was  reason?  How  did  work  done  compare  with  that  done  at  his  best? 

45.  Was  his  work  seasonal  or  otherwise  irregular?  Did  he  always  work  when  he 
could  get  work? 


398 


THE  DESERTED  FAMILY 


46.  What  proportion  of  his  wages  did  he  give  family  when  working  full  time? 
When  working  part  time? 

47.  Has  wife  worked  since  marriage?  At  what  and  for  what  wage?  What  has 
been  effect  on  her  health,  effect  on  man  as  a  wage-earner,  on  home  and  children? 
What  arrangement  was  made  for  the  care  of  the  children  in  her  absence?  Did 
she  consider  work  a  hardship,  or  prefer  it  to  confinement  to  home  duties?  What 
are  her  capabilities  as  a  possible  wage-earner? 

48.  What  is  the  health  record  of  husband?  Of  wife?  Has  either  any  physical  or 
mental  defects?  Has  either  deteriorated  markedly  since  marriage?  Has  either 
been  intemperate  or  given  to  the  use  of  drugs?  (See  Inebriety  Questionnaire, 
p.  430.) 

49-  Has  either  husband  or  wife  been  immoral?  Given  to  gambling,  betting,  or 
any  form  of  dishonesty? 

50.  What  are  husband’s  personal  characteristics?  Has  he  seemed  fond  of  home? 
Of  children?  Or  has  he,  for  example,  been  lazy,  sullen,  penurious,  jealous,  or 
cruel  to  family?  What  is  his  employer’s  estimate  of  him?  What  were  his  re¬ 
lations  with  his  fellow  employes?  If  there  were  marked  signs  of  bad  temper  at 
home  or  in  his  relations  with  shop  mates,  has  the  possibility  of  mental  disease 
ever  been  considered? 

51.  What  are  wife’s  personal  characteristics?  Has  she,  for  instance,  a  difficult  or 
nagging  disposition?  Is  she  a  good  housekeeper?  A  good  mother? 

52.  What  signs  are  there  that  there  has  been  or  still  is  any  real  affection  on  the 
part  of  either  husband  or  wife?  How  have  they  influenced  one  another?  Or  is 
estrangement  due  in  large  part  to  external  things  and  not  to  their  own  disposi¬ 
tions? 

53-  What  active  affiliation  with  church,  with  clubs,  etc.,  has  either  had?  What 
usual  recreations?  Did  family  ever  go  on  trips  or  enjoy  other  recreations  to¬ 
gether? 

54.  Are  the  children  attractive  and  generally  well  cared  for  and  well  behaved? 

55.  What  is  the  attitude  of  the  older  children  toward  their  father?  Toward  their 
mother?  Toward  assuming  support  of  family? 

56.  What  is  the  attitude  of  any  and  all  relatives  toward  husband?  Toward  wife? 
Toward  helping  in  support  of  family  or  other  solution?  Do  his  brothers  or  sis¬ 
ters  or  his  parents  condone  his  desertion?  Are  any  of  them  harboring  him? 

57-  Is  the  present  home  detached,  or  is  it  a  tenement?  Are  the  rooms  pleasant 
and  well  furnished?  Well  cared  for?  Are  any  lodgers  or  other  outsiders  now 
living  with  family? 

58.  What  is  the  character  of  the  neighborhood?  How  long  have  the  family  lived 
in  this  neighborhood?  If  they  have  recently  come  here,  what  was  the  character 
of  their  former  home  and  neighborhood? 

VI  Financial  Situation 

59-  What  is  the  financial  standing  of  husband's  father?  Has  he  contributed  to 
support  of  his  grandchildren?  Has  he  been  prosecuted  for  failure  to  do  so? 

399 


SOCIAL  DIAGNOSIS 


60.  Had  family  been  dependent  before  husband’s  desertion?  To  what  extent, 
how  long,  and  for  what  causes? 

61.  Was  relief  given  from  public  sources,*  from  private  charities,  or  from  relatives? 
Or  had  they  received  free  transportation?  What  had  been  effect  of  aid  on  the 
husband?  On  the  wife? 

62.  Is  family  now  dependent?  On  whom?  To  what  extent?  What  is  the  atti¬ 
tude  toward  the  present  situation  of  those  who  have  assumed  any  part  of  the 
financial  burden? 

63.  What  is  the  total  family  income?  Family  expenditures?  (See  questionnaire 
regarding  Any  Family,  Financial  Situation,  26,  27,  p.  380.) 

64.  Are  the  wage-earning  members  of  family  all  employed  at  maximum  earning 
capacity? 


QUESTIONNAIRE  REGARDING  A  WIDOW  WITH  CHILDREN 

This  is  not  a  schedule  to  be  filled  out  nor  a  set  of  queries  to  be  answered  by  a 
social  agency’s  client  or  clients.  For  an  explanation  of  the  purpose  of  these  ques¬ 
tionnaires  see  p.  373  sq. 

A  star  (*)  indicates  that  the  answer  to  the  question  may  be  found  in,  or  confirmed 
by,  public  records. 

The  questionnaire  regarding  Any  Family  (p.  378)  precedes  this  one.  Its  more 
general  questions  are  repeated  here  only  in  rare  instances,  when  it  has  seemed 
necessary  to  give  them  special  emphasis. 

I  Circumstances  of  Husband’s  Death 

1 .  When  (exact  date)  and  where  did  husband  die?*  Who  was  the  undertaker? 

2.  What  was  the  cause  of  his  death?*  (Give  exact  medical  diagnosis.) 

3.  Were  the  conditions  of  his  work  responsible  for  it?  If  so,  what  action  has  been 
taken  to  secure  compensation?  What  state  law  is  applicable  to  the  situation? 

4.  Had  he  been  physically  weakened  by  overwork?  By  excessive  drinking,  bad 
living  conditions,  or  other  causes? 

5.  How  long  was  he  ill?  What  medical  care  did  he  receive?  Name  and  address 
of  physician  who  attended  him? 

6.  Is  there  anything  important  to  be  noted  in  the  inheritance — physical,  mental, 
or  moral — of  the  husband?  Was  there  in  his  family  tuberculosis,  inebriety,  in¬ 
sanity,  feeble-mindedness,  or  epilepsy? 

7.  How  was  family  supported  during  his  illness?  Were  wages  continued  in  full  or 
in  part  by  his  employers?  What  \yere  the  sources  of  support — relatives,  savings, 
sick  benefits,  wages  of  woman,  of  children,  relief,  other  sources?  Approximate 
amount  from  each  source? 

8.  What  was  the  amount  of  insurance,  legal  compensation,  or  death  benefits? 
Amount  collected  by  fellow  workmen,  contributed  by  employer,  etc.?  Cost  of 
funeral?  Amount  of  debts?  Balance  left  for  widow?  What  disposition  was 
made  of  this  money,  and  how  long  did  it  last? 

400 


THE  WIDOW  WITH  CHILDREN 

II  Early  Life  of  Widow 

9.  What  of  the  family  inheritance  of  the  mother  (see  question  6)? 

10.  What  was  the  occupation  of  her  father?  Did  he  work  steadily  and  fulfill  his 
obligations  to  his  family?  Was  her  home  a  normally  constituted  one?  If  not, 
in  what  particulars  abnormal? 

1 1.  Did  she  before  her  marriage  live  in  the  city  or  country?  Did  she  ever  have  in¬ 
stitutional  care?  Where?  For  how  long?  How  far  did  she  go  in  school?  Why 
and  at  what  age  did  she  leave? 

12.  Did  she  work  before  marriage?  Nature  of  occupation?  Wages?  Length  of 
time  employed  in  each  place?  Wages  at  time  of  marriage? 

13-  If  before  marriage  she  lived  in  another  country,  has  she  worked  since  coming  to 
America?  Nature  of  occupation?  Wages? 

III  Married  Life 

14.  When  (exact  date),  where,  and  under  what  circumstances  did  marriage  take 
place?* 

15-  At  time  of  marriage,  did  either  husband  or  wife  have  any  money  saved?  How 
was  it  spent?  What  was  income  when  first  married?  Character  of  neighbor¬ 
hood  in  which  they  began  married  life?  Was  the  home  better  or  worse  than 
either  had  been  accustomed  to  before  marriage?  Were  they  near  to  relatives? 

16.  Did  they  ever  live  with  relatives?  In  furnished  rooms?  Were  they  separated 
at  any  time?  If  so,  how  long  and  for  what  reason? 

17.  Did  the  wife  work  between  the  time  of  her  marriage  and  her  husband’s  death? 
Occupation?  Length  of  time  employed?  Occasion  for  her  going  to  work? 

18.  What  was  the  husband’s  occupation?  Maximum  wage?  Was  he  regularly, 
seasonally,  or  occasionally  employed?  What  were  his  weekly  earnings  just 
before  he  was  taken  ill?  Did  he  pay  a  regular  amount  weekly  to  his  wife,  or  turn 
over  his  pay  envelope  to  her  untouched?  Was  he  industrially  efficient?  -  Who 
was  his  last  employer?  How  long  was  he  employed  there?  Is  employer  inter¬ 
ested  in  the  family? 

19-  Did  the  family  or  any  member  of  it  have  relief  or  institutional  care  before 
husband  s  last  illness?  When?  Source, t  occasion,  kind,  and  approximate 
amount? 

20.  Did  the  character  of  husband  or  of  wife  change  materially  after  marriage? 
Was  he  intemperate,  vicious,  or  lazy?  When  did  these  characteristics  begin  to 
be  manifested?  Do  any  events  explain  them?  What  was  his  influence  on  the 
children? 

21.  Did  he  ever  desert,  or  had  he  a  court  record?* 

22.  When  did  the  family  reach  its  high-water  mark?  What  was  the  standard  of 
living  at  that  time? 

23.  Was  this  standard  lowered  before  husband's  last  illness?  Why?  In  what 
particulars? 

26 


401 


SOCIAL  DIAGNOSIS 


IV  The  Transition  Period 

24.  Have  any  changes  in  standard  been  made  since  the  husband’s  death?  Re¬ 
moval  to  cheaper  rent?  Children  taken  from  school?  Children  put  in  institu¬ 
tions?  Supply  of  food  or  clothing  reduced?  Lodgers  or  boarders  taken? 
Have  these  changes  been  a  menace  to  the  home  life  and  to  the  future  of  the  chil¬ 
dren? 

25.  How  long  after  husband’s  death  was  the  first  application,  if  any,  for  relief 
made?  To  what  agency?  Treatment  by  that  agency  and  by  any  others  that 
may  have  been  called  on  to  aid  this  family?  Total  (approximate)  amount  of 
relief  given  by  all  agencies  to  date? 

26.  How  was  the  family  supported  in  the  interval  preceding  application?  In¬ 
surance,  relatives,  savings,  sick  benefits,  wages  of  widow,  of  children,  other 
sources? 

V  Present  Surroundings 

27.  What  is  the  character  of  the  neighborhood?  The  house?  The  apartment? 
(For  detailed  questions,  see  questionnaire  regarding  Any  Family,  34-38,  p.  381.) 

28.  How  near  are  they  to  schools,  settlements,  libraries,  parks,  other  opportunities 
for  recreation?  Where  do  the  children  play?  Does  the  family  have  any  recrea¬ 
tion  in  common? 

VI  Present  Family  Problems  in  General 

29.  What  is  the  widow’s  general  health?  Has  she  any  physical  or  mental  disabili¬ 
ties  or  defects?  What  is  the  physical  and  mental  condition  of  each  member  of  the 
household?  If  the  husband  died  of  tuberculosis,  have  all  members  of  the  family 
been  examined? 

30.  Have  any  of  them  had,  in  the  past,  treatment  by  physician,  hospital,  or  dis¬ 
pensary?  With  what  results?  What  was  the  attitude  of  the  patient,  willing¬ 
ness  to  follow  advice,  etc.? 

31.  If  the  mother  or  any  of  the  children  need  medical  care,  what  is  the  diagnosis 
of  physician,  hospital,  dispensary?  What  treatment  or  special  care  is  recom¬ 
mended? 

32.  Is  it  likely  that  any  members  of  the  family  would  be  benefited  by  removal  to 
the  country?  Is  there  anything  to  indicate  that  the  family  would  be  adapted  to 
country  life? 

33.,  What  is  the  widow’s  character  and  ability?  Is  she  moral?  Temperate?  Is 
there  indication  of  strength  of  character?  What  resourcefulness,  if  any?  What 
is  her  attitude  toward  relief,  both  public  and  private? 

34.  In  what  condition  is  her  home  and  the  children’s  clothing?  Is  she  a  thrifty 
housekeeper?  Does  she  know  how  to  select  and  prepare  nourishing  food?  Is 
she  an  affectionate  mother?  Does  she  maintain  discipline,  especially  over  her 
boys? 

35.  Are  the  children  obedient,  well  behaved,  helpful,  of  good  habits?  Have  they 
attended  school  regularly?  What  is  the  teacher’s  report  concerning  them? 
Are  they  up  to  the  normal  grade  in  school?  What  arrangement  has  been  made 

402 


THE  WIDOW  WITH  CHILDREN 


for  receiving  reports  regarding  attendance,  etc.,  from  week  to  week?  Have 
they  ever  been  under  the  care  of  a  truant  officer?*  Have  any  of  them  been  before 
the  children  s  court?*  If  so,  under  what  circumstances  and  with  what  results? 

36.  Do  any  of  the  family  take  advantage  of  clubs  or  social  activities  in  schools, 
settlements,  etc.?  What  is  the  testimony  of  the  directors  of  such  activities  in 
regard  to  them? 

37.  If  the  family  is  foreign,  what  is  the  degree  of  Americanization?  Does  the 
mother  speak  English?  What  influence  have  differences  in  custom  on  her  rela¬ 
tions  with  the  children?  (See  also  Immigrant  Family  Questionnaire,  p.  387.) 

38.  Are  there  other  members  of  the  household?  Boarders  and  lodgers?  What  is 
the  effect  of  their  presence  on  the  family  life?  Are  any  of  these  male  adults? 
Are  they  related  to  the  widow? 

39.  Does  the  mother  plan  to  put  any  of  the  children  in  institutions?  If  so,  what  are 

her  reasons?  Or  what  other  plans  has  she  in  detail  for  herself  and  for  each  of 
her  children? 

VII  Present  Work  Problems 

40.  If  the  widow  is  not  working,  is  her  constant  presence  with  the  children  needed? 
Is  it  good  for  them,  or  would  they  both  gain  by  periods  of  absence?  How  does 
she  spend  her  time?  What  are  the  work  standards  of  women  in  the  neighbor¬ 
hood  who  have  working  husbands?  How  much  and  what  kind  of  work,  if  any, 

should  she  be  expected  to  do?  Would  she  be  helped  in  ways  other  than  financial 
by  further  training? 

41.  If  employed,  what  is  the  nature  of  her  occupation?  What  are  her  weekly 
earnings?  Working  hours,  and  total  hours  per  day?  Does  she  go  out  to  work? 
If  so,  how  many  days  per  week  and  for  what  specific  hours  of  the  day  (A.  M.  and 

P.  M.)  is  she  away  from  home?  If  she  is  working  early  and  late  hours,  how  much 
sleep  does  she  get? 

42.  If  the  mother  works  away  from  home,  where  is  each  of  the  children  under 
working  age  in  her  absence?  Who  cooks  their  meals?  Do  they  get  food  enough 
and  of  the  right  kind?  Who  cares  for  them?  If  a  neighbor  does,  what  is  her 
character  and  influence?  What  provision  is  made  for  care  of  school  children 
out  of  school  hours? 

43-  Do  the  children  of  school  age  help  their  mother  at  home?  Do  they  sell  papers, 
run  errands,  or  do  any  work  outside  the  home?  If  so,  what  are  the  days  and 
hours  of  work  and  amount  earned?  Is  the  child  labor  law  being  violated? 

44-  What  are  the  conditions,  moral  and  physical,  under  which  widow  and  children 

work?  If  she  works  at  home,  do  conditions  comply  with  regulations  of  factory 
inspectors? 

45-  Are  the  children  of  working  age  at  work  and  earning  maximum  possible  wages? 
Will  their  present  occupation  lead  to  advancement?  Have  they  special  talents 
to  be  cultivated?  What  are  their  earnings? 

46.  What  is  their  attitude  toward  assuming  family  responsibility?  Do  they  give 
mother  full  wage?  Does  she  allow  them  money  for  clothes  and  spending  money? 

403 


SOCIAL  DIAGNOSIS 


47.  Is  any  effort  being  made,  as  younger  children  approach  working  age,  to  secure 
for  them  work  suited  to  their  preferences  or  abilities  that  will  train  them  for  fu¬ 
ture  efficiency?  What  is  the  mother's  attitude  toward  their  further  education? 

VIII  Income  and  Outgo 

48.  What,  in  detail,  is  the  present  income  of  the  family?  The  present  outgo?  (See 
questionnaire  regarding  Any  Family,  26,  27,  p.  380.) 

49.  What  does  careful  analysis  show  to  be  the  necessary  expenditure  for  food,  rent, 
fuel,  clothing,  insurance,  carfare,  lunches,  other  items? 

IX  Possible  Sources  of  Advice  and  Help 

50.  Are  there  relatives  near  at  hand?  Are  they  friendly?  What  plan  for  the 
widow’s  future  do  they  advise?  What  material  help  can  they  give  in  carrying  it 
out?  What  helps  that  are  not  material?  What  is  their  moral  standing?  Is 
their  influence  desirable?  If  they  live  in  another  community  in  the  United  States 
or  in  the  old  country,  could  the  family  go  to  live  with  them?  Are  any  of  them 
known  to  any  social  agency?  If  the  husband  was  a  member  of  a  lodge  or  benefit 
society,  is  the  man  who  stood  sponsor  for  him  an  old  friend  whose  advice  might 
prove  valuable? 

51.  Has  the  family  attended  church  or  Sunday  school  regularly?  Is  there  any 
religious  instruction  at  home?  What  help  can  the  church  give,  either  material 
or  by  supervision,  encouragement,  etc.? 

52.  Are  any  charities  or  other  social  agencies  interested?  If  so,  what  plan  do  they 
advise? 

53.  Are  there  any  other  sources  of  information  and  advice  as  to  future  plans? 
Any  other  sources  of  material  help?  Friends?  Previous  employers?  Trade 
unions? 


CHAPTER  XXIII 
THE  NEGLECTED  CHILD 

IT  SEEMED  best  to  Dr.  Catherine  Brannick,  who  prepared 
the  questionnaire  regarding  a  Neglected  Child  which  follows, 
to  classify  nearly  half  of  her  material  on  the  basis  of  the  par¬ 
ticular  forms  of  neglect  recognized  in  many  of  our  states  as  statu¬ 
tory  offenses.  This  was  done  to  facilitate  reference,  but  it  has 
involved  repeating  under  each  form  listed  questions  that  apply  to 
several  forms.  The  court  side  is  only  one  aspect  of  this  important 
problem,  but  it  is  a  side  with  which  social  workers  have  to  make 
themselves  familiar. 

QUESTIONNAIRE  REGARDING  A  NEGLECTED  CHILD1 

This  is  not  a  schedule  to  be  filled  out  nor  a  set  of  queries  to  be  answered  by  a 
social  agency’s  client  or  clients.  For  an  explanation  of  the  purpose  of  these  ques¬ 
tionnaires  see  p.  373  sq. 

A  star  ( ')  indicates  that  the  answer  to  the  question  may  be  found  in,  or  confirmed 
by,  public  records. 

The  questionnaire  regarding  Any  Family  (p.  378)  precedes  this  one.  Its  more 
general  questions  are  repeated  here  only  in  rare  instances,  when  it  has  seemed  neces¬ 
sary  to  give  them  special  emphasis. 

I  The  Child's  Father 

1.  Is  there  any  criminal  tendency  in  his  family?  Any  record  of  drunkenness, 
chronic  dependence,  unusual  degree  of  immorality,  physical  degeneracy? 

2.  Were  any  members  of  his  family  insane,  feeble-minded,  or  epileptic? 

3.  Was  he  born  out  of  wedlock? 

4-  Were  there  elements  of  neglect  or  cruelty  in  his  own  childhood?  Was  he  a 
spoiled  or  unrestrained  child? 

5.  Was  he  country  or  city  bred?  What  was  the  character  of  the  community  in 
which  he  was  reared? 

6.  Was  he  brought  up  to  attend  any  church?  What  was  his  religious  education? 

7.  What  was  his  school  training?  His  record  at  school?  Was  he  considered  in 
any  degree  mentally  defective?  Did  he  show  signs  of  unusual  temper,  inherent 
cruelty,  moral  degeneracy?  Age  and  grade  on  leaving  school?  Reason  for 
leaving  school?  Did  he  have  any  special  training? 

1  Prepared  for  this  volume  by  Dr.  Catherine  Brannick. 

405 


SOCIAL  DIAGNOSIS 


8.  Did  he  have  any  record  of  juvenile  delinquency?*  What,  in  detail? 

9.  Was  he  ever  an  inmate  of  a  children’s  home  or  institution?  If  so,  under  what 
circumstances?  For  how  long?  If  he  was  in  an  institution  or  otherwise  a  public 
charge,  at  what  age  did  supervision  cease?*  What  was  his  reputation? 

10.  If  foreign  born,  at  what  age  and  under  what  circumstances  did  he  begin  life 
in  the  United  States? 

1 1.  At  what  age  did  he  begin  work?  What  kind  of  work  was  it?  Was  it  of  such 
nature  as  to  have  a  bad  effect  on  him  physically  or  otherwise?  (i.  e.,  was  it  a 
dangerous  trade,  a  seasonal  trade,  irregular  work,  etc.?) 

12.  What  was  his  attitude  toward  his  parents?  Did  he  show  neglect  of  filial  duties 
in  withholding  wages,  etc.?  Was  he  actively  abusive? 

13.  Did  he  work  whenever  possible,  or  did  he  show  a  tendency  to  loaf? 

14.  What  in  general  were  his  habits?  What  were  his  recreations? 

15.  Is  there  record  in  lower  or  superior  court  of  any  charge  or  conviction?  For 
what  offense?* 

II  The  Child’s  Mother 

16.  What  were  the  characteristics  and  standing  of  the  mother’s  parents  and  of  her 
immediate  family?  The  circumstances  of  her  early  home  life?  Was  she  her¬ 
self  a  neglected  child?  What  was  her  schooling?  Was  she  regarded  as  a  dull 
or  difficult  child?  What  work  did  she  take  up  after  leaving  school?  Did  she 
ever  have  any  training  in  her  home  or  elsewhere  to  fit  her  for  domestic  life? 
What  kind  of  associates  did  she  choose?  Was  she  ever  committed  to  an  indus¬ 
trial  or  reform  school?*  Was  she  known  as  a  girl  of  “loose  habits”?  (For  de¬ 
tails  that  apply,  see  The  Child’s  Father,  1  to  15.) 

III  The  Family  Life 

17.  Has  either  the  father  or  the  mother  ever  been  married  before?*  If  so,  is  former 
wife  or  husband  living?  If  divorced,  where  and  on  what  ground  was  divorce 
obtained?* 

18.  Has  either  parent  any  children  by  a  former  marriage  or  any  illegitimate  chil¬ 
dren?  If  so,  how  many  are  there,  what  are  their  ages  and  sexes,  where  are  they, 
and  what  are  their  relations  with  their  parents  and  stepparents?  If  any  such 
children  have  died,  what  was  the  cause  of  death?*  If  any  are  living  with  the 
family,  is  marked  partiality  shown  by  stepparent  to  his  or  her  own  children? 

19.  Are  the  father  and  mother  legally  married?  When,  where,  and  by  whom  was 
the  ceremony  performed?*  What  were  the  circumstances  of  the  marriage? 
Was  it  a  forced  one?  How  old  were  the  parents  at  the  time?  How  long  had 
they  known  each  other? 

20.  Are  there  any  mental  or  physical  defects  in  either  parent  that  should  have 
barred  marriage? 

21.  Are  there  family  difficulties  between  husband  and  wife  due  to  racial  or  reli¬ 
gious  differences?  To  unwise  interference  by  relatives?  Are  differences  so  serious 
that  they  are  not  likely  ever  to  be  overcome? 

406 


THE  NEGLECTED  CHILD 


22.  How  many  children  have  been  born  of  this  marriage?  How  many  have  died, 
and  from  what  causes?* 

23.  What  was  the  father’s  occupation  at  the  time  of  marriage?  Since?  Was  he 
then  and  has  he  since  been  earning  enough  to  support  a  family?  Has  he  given 
his  family  normal  support?  When  did  family  reach  its  high-water  mark  and 
what  were  the  conditions? 

24.  If  the  father  is  now  working,  what  are  his  wages?  What  proportion  of  his 
total  income  does  he  give  to  his  family?  What  is  his  employer’s  estimate  of 
him?  What  is  his  attitude  toward  his  fellow  employes? 

25.  How  does  his  present  wage  compare  with  that  which  he  is  capable  of  earning — 
his  maximum  wage?  What  is  reason  for  lower  wage?  How  does  present  type 
of  work  compare  with  work  done  at  his  best? 

26.  How  does  the  home  now  provided  by  him  compare  with  that  which  he  is  able  to 
provide? 

27.  If  he  is  not  working,  what  is  the  reason?  How  long  has  he  been  out  of  work? 

28.  Is  he  a  member  of  a  trade  union?  What  is  his  reputation  in  the  union?  Is  he 
a  member  of  any  fraternal  organization?  Affiliated  with  any  anti-social  organi¬ 
zation? 

29.  Is  he,  or  has  he  ever  been,  a  satisfactory  husband  and  father?  Fond  of  home 
life?  Of  his  children?  Or  does  he  regard  children  as  merely  a  means  of  support 
for  himself,  now  or  later? 

30.  If  satisfactory  at  one  time  and  now  given  to  abuse  or  neglect,  when  did  change 
take  place?  Was  it  apparently  due  to  development  of  inherent  bad  qualities? 
To  “easy  disposition,”  bad  companionship  and  surroundings?  To  discourage¬ 
ment  over  lack  of  work,  long  illness  in  family,  debt,  characteristics  of  wife  as  a 
homemaker? 

31.  What  is  the  attitude  of  the  children  toward  their  father  and  mother?  Have 
they  real  affection  for  them?  Are  they  afraid  of  either  of  them?  Are  they  con¬ 
trolled  by  either  or  both?  How?  By  fear  or  otherwise? 

32.  Is  the  wife,  or  has  she  ever  been,  a  good  mother  or  satisfactory  housekeeper? 
If  her  home  standards  were  fair  at  one  time  and  have  since  become  low,  what 
causes  have  contributed  to  lower  them?  Her  own  or  her  husband’s  habits? 
Her  own  illness  or  other  illness  in  the  family?  Overwork?  Too  many  children? 
Extreme  poverty? 

33.  Is  she  obliged,  or  has  she  in  the  past  been  obliged,  to  contribute  to  the  family 
support?  To  what  extent?  Has  she  had  the  burden  of  regular  work  away  from 
home?  Is  this  responsible  for  much  of  the  neglect? 

34.  Is  or  has  either  parent  ever  been  affiliated  with  any  church?  What  is  present 
relation  to  the  church  and  clergy? 

35.  What  are  the  habits  of  father  and  mother  as  affecting  their  family  life?  Does 
either  drink  to  excess?  (See  Inebriety  Questionnaire,  p.  430.)  In  the  home,  or 
away  from  it?  Does  drinking  bring  dissolute  companions  into  the  home?  Has 
either  parent  ever  signed  the  pledge  or  has  either  any  respect  for  it?  Does 

407 


SOCIAL  DIAGNOSIS 


either  use  drugs?  Is  either  immoral?  Obscene  in  language  or  action  before 
the  children?  Is  father  a  loafer?  Does  mother  neglect  her  household  duties, 
spend  much  time  away  from  home  or  in  association  with  criminal  or  immoral 
persons?  Has  either  an  ugly  or  dangerous  temper?  Does  either  beat  or  otherwise 
abuse  the  children?  Is  either  given  to  gambling?  Dishonest?  Quarrelsome? 

36.  Is  either  parent  suffering  from  a  disease  that  constitutes  a  menace  to  the 
family?  Is  there  reliable  evidence  of  this  condition  in  hospital  records  or  with 
a  competent  private  physician?  What  is  the  date  of  this  record? 

37.  Does  the  bad  example  of  either  parent  show  in  the  conduct  of  any  of  the  chil¬ 
dren?  Do  they  imitate  parental  vices? 

38.  Is  either  parent  known  to  the  police  of  the  district,  and  what  is  his  or  her  repu¬ 
tation  with  them? 

39.  Has  either  a  court  record?*  Has  the  father  been  accused  or  convicted  of  of¬ 
fenses  against  his  family— of  desertion,  non-support,  assault,  cruelty,  criminal 
abuse?*  Has  the  mother?* 

40.  Is  either  parent  by  reason  of  mental  or  physical  defects,  disposition,  or  habits 
unfit  to  have  the  care  of  children?  On  what  grounds?  Is  there  medical  author¬ 
ity  for  this?  Has  either  ever  been  pronounced  mentally  irresponsible?  Would 
mental  examination  now  be  likely  to  result  in  such  a  decision? 

IV  Particular  Form  of  the  “Neglect” 

(a)  Desertion  or  failure  to  provide  for  home 

41.  Have  the  parents,  or  either  of  them,  deserted?  How  long  ago?  Under  what 
circumstances?  Is  this  the  first  desertion?  If  not,  what  is  history  of  previous 
desertions?  (For  other  questions  on  desertion,  see  Deserted  Family  Question¬ 
naire,  p.  395.) 

42.  How  many  rooms  in  the  home?  Is  there  overcrowding  beyond  that  which  the 
law  or  decency  allows? 

43.  Is  the  home  furnished  sufficiently  for  decent  living  and  privacy? 

44.  What  are  the  sleeping  arrangements?  Is  there  a  decent  supply  of  bedding? 
How  many  sleep  in  each  bed?  Are  children  forced  to  sleep  with  parents,  adult 
members  of  family,  or  lodgers?  Do  children  sleep  in  a  dark  room? 

45.  Are  the  children  decently  clothed?  How  does  their  clothing  compare  with 
that  of  other  children  of  the  neighborhood? 

46.  Have  the  children  sufficient  food?  How  is  it  prepared  and  served?  What 
did  the  children  actually  have  to  eat  at  certain  meals?  If  there  is  an  infant,  how 
is  it  fed? 

47.  What  is  the  testimony  of  the  teacher  or  school  nurse  in  regard  to  these  facts? 

48.  How  long  has  this  condition  of  neglect  existed? 

(b)  Neglect  to  provide  medical  care 

49.  Are  any  of  the  children  suffering  from  physical  defects  or  diseases — such  as 
deformities,  rickets,  persistent  cough,  chorea  or  other  nervous  affection,  anemia, 

408 


THE  NEGLECTED  CHILD 


malnutrition,  adenoids,  skin  disease,  carious  teeth,  pediculosis,  defective  eye¬ 
sight  which  can  be  remedied  by  proper  medical  care  which  the  parents  have 
been  able  but  have  failed  to  provide? 

50.  Has  any  one  of  the  children  syphilis  or  gonorrhea?  What  was  the  probable 
source  of  infection?  Is  he  receiving  treatment  for  this?  Is  his  condition  a 
menace  to  other  children?  Is  there  past  history  of  these  diseases? 

51.  Is  either  parent  or  any  frequenter  of  the  home  suffering  from  venereal  or  other 
contagious  disease?  Is  there  medical  authority  for  this?  Of  what  date?  Are 
conditions  such  that  the  children  are  inevitably  exposed  to  contagion  from  this? 

52.  Is  there  record  of  the  physical  ills  of  the  children  with  the  school  nurse  or  doc¬ 
tor,  district  nurse  or  physician,  hospital  or  competent  private  physician?  With 
the  board  of  health?* 

53.  What  efforts  have  been  made  through  other  agencies  to  persuade  the  parents 
to  secure  proper  medical  care  for  the  children?  With  what  results? 

54.  What  is  the  testimony  of  these  agencies?  Is  further  effort  by  them  likely  to 
be  successful? 

55.  Has  the  school  physician  power  to  act  in  the  matter? 

56.  Is  the  neglect  of  such  nature  that  the  board  of  health  has  power  to  act? 

57.  Was  the  diagnosis  of  the  neglected  condition  specified  in  the  complaint  made  by 
a  recognized  medical  authority  whose  word  would  be  taken  in  court? 

58.  Is  it  likely  that  any  other  recognized  medical  authority  would  disagree  with  the 
first? 

59.  Have  any  children  of  the  family  died?  When  and  from  what  causes?*  Do 
the  deaths  show  probable  medical  neglect?  Were  such  children  insured? 

(c)  Lack  of  control 

60.  Is  there  lack  of  ordinary  parental  guidance?  Are  the  parents  able  or  do  they 
try  to  control  the  children? 

61.  Do  the  difficulties  of  a  new  country  press  upon  the  parents?  Do  the  children 
take  advantage  of  this? 

62.  What  is  the  school  record  of  the  children,  especially  as  to  attendance  and  be¬ 
havior?  Are  they  truant?  In  their  language  or  habits  at  school  do  they  show 
the  lack  of  salutary  control? 

63.  Are  the  children  constantly  on  the  streets  and  late  at  night?  Do  they  frequent 
low  picture  shows,  visit  saloons  or  other  places  likely  to  lead  to  an  idle  and  dis¬ 
solute  life? 

64.  Has  the  lack  of  salutary  control  reached  the  point  where  wrong-doing  is  a  habit 
and  the  child  is  delinquent?  Is  there  record  of  habitual  truancy?  Theft? 
Immoral  conduct  or  association  with  immoral  persons?  Frequenting  houses  of 
ill  repute?  Street  walking?  Begging  or.  .vagrancy?  Use  of  vile  language? 
Relative  incorrigibility? 

65.  Have  any  of  the  children  any  juvenile  or  other  court  record?* 

409 


SOCIAL  DIAGNOSIS 


66.  Have  any  of  the  delinquent  children  been  pronounced  defective?  If  so,  has  cus¬ 
todial  care  been  refused  by  the  parents  or  not  been  provided  by  the  community? 

(d)  Exploitation 

67.  Are  the  children  overworked  in  home  duties? 

68.  Are  they  illegally  employed?  Before  the  legal  age  or  at  illegal  hours? 

69.  Are  they  made  to  contribute  to  the  family  support  by  sweatshop  work  in  the 
home?  By  unreasonable  help  in  the  business  of  their  parents? 

70.  Are  they  sent  upon  the  streets  to  beg?  Are  they  sent  out  ostensibly  to  sell 
articles  on  the  street,  but  really  to  use  this  as  a  means  of  begging? 

71.  Is  there  deliberate  exploitation  ol  the  children  for  immoral  purposes? 

(e)  Cruelty,  physical  injury,  or  abuse 

72.  Is  parental  discipline  rigid  to  the  point  of  cruelty?  Is  punishment  given  by 
parent  when  in  anger,  or  is  self-control  exercised?  Is  punishment  frequent, 
oversevere,  of  unnatural  or  cruel  form,  dictated  by  perverted  religious  ideas,  etc.? 
Is  there  abusive  treatment  not  associated  with  the  idea  of  punishment? 

73.  Are  the  older  children  permitted  to  punish  or  abuse  the  younger? 

74.  Do  the  children  show  evidence  of  such  abuse  or  punishments? 

(f)  Moral  neglect 

75.  Is  the  neighborhood  of  bad  reputation?  Are  there  people  of  bad  reputation 
in  the  same  house?  Are  the  sleeping  arrangements  of  the  home  such  that  decent 
privacy  is  impossible? 

76.  Are  the  children  exposed  to  lead  an  idle  and  dissolute  life  by  the  drinking  of  the 
parents?  By  liquor  selling  in  the  home?  Have  the  police  knowledge  of  liquor 
selling?  Are  the  children  exposed  to  moral  contagion  by  the  immorality  of  the 
parents?  By  obscene  acts  and  language  of  the  parents  in  presence  of  the  chil¬ 
dren?  By  the  presence  of  lodgers  or  others  admitted  to  the  home? 

77.  Are  the  children  known  as  “young  street  walkers”?  Have  the  parents  been 
aware  of  such  practice  or  have  they  deliberately  encouraged  it? 

78.  Are  the  children  of  bad  moral  reputation  in  the  neighborhood?  In  the  school? 
Is  there  evidence  of  unnatural  relations  between  parents  and  children?  Between 
the  children? 

79.  Is  there  reliable  record  of  physical  examination  of  any  of  the  children  showing 
venereal  disease  or  evidence  of  immoral  relations? 

(g)  Inducement  of  chronic  dependence 

80.  Are  the  parents  now  or  have  they  been  frequently  in  receipt  of  charitable  aid 
either  public  or  private  for  which  their  neglect  is  responsible? 

81.  Have  the  parents  or  children  ever  been  inmates  of  public  institutions?*  Under 
what  circumstances? 

82.  Is  there  record  of  dependency  in  the  case  of  grandparents,  uncles,  aunts? 

83.  What  is  the  testimony  of  public  relief-giving  agencies  regarding  family? 

84.  What  is  the  attitude  of  parents  and  children  toward  relief? 

410 


THE  NEGLECTED  CHILD 


85.  Has  family  been  aided  by  many  private  relief  agencies?  Have  parents 
“worked”  these  agencies?  What  is  testimony  of  these  private  agencies  in  regard 
to  the  effect  on  the  children? 

86.  Are  parents  known  to  beg? 

87.  Are  the  children  permitted  or  compelled  by  parents  to  ask  for  relief  at  offices  of 
public  or  private  relief  agencies? 

88.  Do  children  show  tendency  to  dependency  in  their  habits?  Are  they  known  to 
beg  with  or  without  knowledge  of  their  parents?  What  is  the  testimony  of  the 
school  in  regard  to  this? 

V  General  Aspects  of  the  “Neglect” 

89.  Is  the  neglect  more  truly  destitution?  Is  it  the  direct  result  of  half  orphanage, 
illness  of  the  parents,  lack  of  work,  or  other  unfortunate  circumstances  for  which 
the  parents  are  not  responsible?  Are  the  children  more  truly  dependent  than 
neglected? 

90.  If  present  condition  has  elements  of  dependency  rather  than  neglect,  is  it  the 
result  of  neglect  and  vice  at  an  earlier  period  of  the  family  life? 

91.  Is  condition  due  in  any  part  to  racial  habits  or  characteristics?  Does  the  stan¬ 
dard  of  the  family  compare  favorably  enough  with  the  standards  of  the  particular 
race  or  social  group? 

92.  Is  the  condition  one  of  all-round  neglect  which  has  reached  the  point  where  it 
is  not  sufficiently  bad  for  court  interference  and  yet  too  bad  for  any  hope  from 
constructive  work?  Is  the  only  possible  thing  to  wait  (though  with  continued 
close  supervision)  for  conditions  to  become  worse? 

93.  Is  neglect  of  such  degree  or  character  that  remedy  may  be  reached  by  prosecu¬ 
tion  of  parents  leading  to  probation? 

94.  Is  the  father  so  nearly  wholly  responsible  for  the  neglect  that  action  against 
him  would  be  more  just  than  the  more  general  charge  of  neglect,  which  involves 
the  mother?  Is  non-support  the  main  factor?  Frequent  desertion?  Can  the 
mother  be  persuaded  to  testify  to  this  or  to  bring  the  charge  herself? 

95.  Has  the  home  ever  before  been  broken  up?  By  reason  of  the  (temporary) 
inability  of  the  parents  to  provide  a  home?  By  court  action?*  How  was  the 
home  re-established?  Have  the  children  ever  been  inmates  of  a  home  or  institu¬ 
tion  and  under  what  circumstances? 

96.  Are  the  conditions  of  neglect  recent  or  of  long  standing?  What  is  the  critical 
point  in  the  neglect  which  led  to  the  complaint? 

97.  Is  the  complainant  a  reliable  person?  Is  the  complainant  possibly  irrespon¬ 
sible,  biased,  or  vindictive?  Is  he  willing  to  testify  if  necessary  to  the  conditions 
of  which  he  has  made  complaint? 

98.  Is  there  first-hand  evidence  of  the  conditions  of  neglect?  By  the  complainant? 
By  the  police?  By  reliable  neighbors?  By  unbiased  relatives?  By  the  worker 
himself?  Can  specific  instances  be  cited?  Have  night  visits  been  made  to  as¬ 
certain  exact  sleeping  conditions  or  presence  of  undesirables  in  the  household? 

411 


SOCIAL  DIAGNOSIS 


99.  Is  any  of  the  evidence  likely  to  be  attacked  as  prejudiced? 

100.  Can  the  parents  themselves  be  persuaded  to  admit  the  charges  of  neglect? 

10 1.  If  evidence  of  any  one  of  the  children  seems  necessary  or  desirable,  has  the  re¬ 
liability  of  the  child  been  investigated  through  the  school,  Sunday  school,  or 
other  responsible  source? 

102.  What  is  the  attitude  of  the  police  toward  the  specific  form  of  neglect?  Of 
the  court?  Of  the  community? 

103.  Are  there  responsible  relatives?  Have  these  relatives  in  the  past  made  any 
attempt  to  build  up  the  family  life?  Can  they  be  depended  upon  to  take  charge 
of  the  family  without  appeal  to  the  court? 

104.  Is  it  best  to  make  the  appeal  to  the  court  first,  for  the  purpose  of  working  out 
plans  with  relatives  under  the  court’s  direction  or  with  its  co-operation? 

105.  Is  more  satisfactory  disposition  possible  without  court  action?  If  warrant 
for  neglect  is  not  advisable  or  possible,  is  informal  summons  and  warning  by  court 
possible? 

106.  If  the  state  laws  are  such  that  the  charge  of  neglect  is  made  against  the  child, 
and  the  law  provides  for  prosecution  of  the  parent  by  an  independent  action,  have 
plans  been  made  for  such  action? 

VI  Work  of  Other  Agencies 

107.  Has  family  been  known  to  other  social  agencies?  If  so,  what  is  the  testimony 
of  these  agencies  regarding  it,  what  has  been  their  experience  in  attempts  at  con¬ 
structive  work,  and  what  do  they  advise? 

108.  Has  probation  been  tried  in  the  case  of  either  parent?  With  what  success? 

109.  Is  constructive  work  of  any  one  of  these  or  other  agencies  likely  to  succeed 
if  strengthened  by  action  on  the  part  of  the  social  agency  charged  with  responsi¬ 
bility  of  protecting  children  from  neglect?  Is  any  one  agency,  by  reason  of  pres¬ 
tige  or  standing  with  family,  more  peculiarly  fitted  to  undertake  such  work? 

1 10.  Is  the  consensus  of  opinion  of  these  agencies  that  further  effort  at  constructive 
work  with  the  family  is  useless? 


J 


412 


CHAPTER  XXIV 

THE  UNMARRIED  MOTHER 

WE  HAVE  seen  earlier  that  the  affixing  of  a  label — even  of 
a  correct  label — has  no  practical  bearing  upon  prognosis 
and  treatment,  and  that  a  classification  of  this  sort  is  not 
a  social  diagnosis.  This  truth  has  been  illustrated  in  the  dealings  of 
social  agencies  with  the  mother  of  an  illegitimate  child.  There 
are  few  tasks  requiring  more  individualization,  and  there  are  few 
in  which  there  has  been  so  little. 

Mrs.  Sheffield,  in  the  questionnaire  regarding  an  Unmarried 
Mother  which  follows,  aims  to  bring  out  first,  under  the  captions 
The  Mother  and  The  Father,  certain  facts  of  environment  and 
early  influence  together  with  the  outstanding  traits  of  these  two 
people  which  may  throw  light  on  their  standards  of  conduct  and 
habits  of  thought.  Although,  in  our  treatment  of  an  unmarried 
woman  or  girl  in  this  situation,  we  are  liable  to  overlook  her  father, 
it  is  obvious  that  his  characteristics  and  what  went  to  mould  them 
are  quite  as  significant  socially  as  those  of  her  mother.  The  in¬ 
formation  may  point  the  way  not  only  to  effective  treatment  in  the 
particular  case,  but  also  to  measures  for  mass  betterment  in  the 
community. 

The  last  part  of  the  questionnaire  calls  for  the  more  immediate 
explanation  of  the  girl’s  or  woman’s  situation  and  for  facts  bearing 
on  the  identity  and  responsibility  of  the  man.  For  various  reasons 
the  child’s  father  only  too  frequently  escapes  responsibility.  Evi¬ 
dence  of  paternity  may  not  be  convincing,  the  man  may  dis¬ 
appear,  or  the  social  agency — occupied  with  many  other  tasks — 
may  feel  that  the  small  amount  which  the  mother  would  be  likely 
to  receive  does  not  warrant  the  labor  of  establishing  the  man’s 
whereabouts  and  of  bringing  him  to  trial.  The  question  has  other 
aspects,  however.  Even  small  sums,  if  required  whenever  pa¬ 
ternity  can  be  established,  will  have  an  influence  in  modifying 

413 


SOCIAL  DIAGNOSIS 


public  opinion,  will  lead  it  to  hold  a  man  as  well  as  a  woman 
answerable  for  the  support  of  offspring. 

In  making  final  arrangements  for  mother  and  child,  their  physi¬ 
cal  welfare,  including  the  mother’s  fitness  for  giving  the  baby 
proper  care,  is  of  course  of  primary  concern.  The  need  of  facts  that 
bear  on  the  choice  of  work  and  surroundings  for  the  mother  herself 
is  indicated  by  earlier  questions.  And  it  should  not  be  necessary 
to  emphasize  an  unmarried  mother’s  need  for  wise  supervision — 
whether  she  keeps  her  infant  with  her  or  not. 

QUESTIONNAIRE  REGARDING  AN  UNMARRIED  MOTHER1 

This  is  not  a  schedule  to  be  filled  out  nor  a  set  of  queries  to  be  answered  by  a 
social  agency’s  client  or  clients.  For  an  explanation  of  the  purpose  of  these  ques¬ 
tionnaires  see  p.  373  sq. 

A  star  (*)  indicates  that  the  answer  to  the  question  may  be  found  in,  or  confirmed 
by,  public  records. 

The  preliminary  social  questions  regarding  the  husband  and  wife  contained  in 
the  questionnaire  regarding  Any  Family,  p.  378 — those  regarding  names,  ages, 
nationality,  religion,  language  spoken,  length  of  residence  in  city,  state,  and 
country — may  be  assumed  to  apply  to  the  Unmarried  Mother,  and  (in  cases  in 
which  she  is  sure  who  he  is)  to  the  father  of  her  child. 

I  The  Mother 

Her  family  and  home 

1.  Did  or  does  she  live  with  her  own  parents?  Is  she  legitimate?  Adopted? 
Did  she  ever  live  in  an  institution,  and  if  so,  when,  how  long,  and  why?  What 
is  the  standing  of  parents  in  the  community?  Are  they  self-supporting,  self- 
respecting  people?  Is  the  home  clean  and  respectable  looking?  Was  her  par¬ 
ents’  marriage  forced?  Did  her  mother  or  sisters  have  illegitimate  children? 
Were  these  children  kept  with  their  mothers,  or  what  became  of  them? 

2.  Are  (or  were)  parents  fond  of  children?  Even-tempered  or  irritable?  Faithful 
to  church?  Earnest  or  indifferent  as  to  moral  standards?  Lax  or  firm  in  con¬ 
trol  (for  instance,  are  they  conscientious  in  overseeing  their  daughters’  recrea¬ 
tions;  did  the  mother  teach  her  daughters  housework,  instruct  them  in  sex 
hygiene)?  Or  oversevere  (for  instance,  are  they  reasonable  in  allowing  pleasures 
and  part  of  earnings)? 

Her  community 

3.  What  is  the  character  of  the  city  quarter  or  town  in  which  the  girl  or  woman 
grew  up — in  size,  race,  religion,  general  moral  standards,  faithfulness  to  church, 
predominating  occupation,  if  any,  recreations  and  social  life?  Is  it  a  factory 
town,  farming  region,  or  what  is  its  industrial  character?  Has  it  distinct  foreign 
colonies? 


1  Prepared  for  this  volume  by  Mrs.  Ada  Eliot  Sheffield. 

414 


THE  UNMARRIED  MOTHER 


4.  If  she  came  from  a  small  town  or  village  is  it  within  easy  distance  of  a  large  city? 
Do  her  companions  have  local  amusements  or  do  they  go  to  the  city  for  them? 
Are  their  pleasures  supervised? 

5.  Are  the  schools  good  from  academic,  vocational,  and  social  standpoints? 

6.  Are  the  local  police  alert  towards  loose  behavior  on  the  streets?  Are  saloons, 
dance  halls,  etc.,  regulated  well?  Are  they  numerous  in  proportion  to  the  popu¬ 
lation?  Is  the  judge  in  the  local  police  court  interested  in  the  welfare  of  boys 
and  girls? 

7.  What  is  the  proportion  of  illegitimate  births  in  the  girl’s  or  woman’s  native 
town  or  country?*  Does  custom  there  treat  the  offense  as  a  slight  one,  or  is 
ostracism  relentless?  Do  pregnant  girls  frequentlydeave  to  hide  their  condition 
and  dispose  of  the  child  elsewhere?  Is  this  region  equipped  to  care  for  such 
girls?  If  not,  why?  If  it  is,  what  co-operative  understanding  has  been  estab¬ 
lished  with  local  agencies? 

8.  Are  the  local  doctors  and  clergymen  (if  a  small  community)  awake  to  the  prob¬ 
lem?  What  attitude  do  they  take  in  regard  to  young  unmarried  mothers  keep¬ 
ing  their  babies? 

The  mother  herself 

9.  What  was  her  health  as  a  child?  At  what  age  did  she  mature?  Has  she  any 
physical  peculiarity  or  deformity?  Is  there  any  evidence  that  she  is  mentally 
deficient  or  abnormal? 

10.  Did  her  parents  say  that  she  was  troublesome  as  a  child?  If  so,  how?  Did 
she  disobey  her  parents,  fail  to  heed  their  advice,  was  she  disrespectful  to  them? 
Did  she  frequent  candy,  ice  cream,  or  fruit  stores  for  diversion?  What  sort  of 
associates  did  she  have  while  she  was  growing  up?  How  have  they  turned  out? 
Can  her  parents  throw  light  on  the  reasons  for  her  behavior,  if  loose?  Of  what 
sort  are  her  present  girl  or  women  friends? 

1 1.  When  her  parents  learned  she  was  pregnant,  what,  if  any,  plans  did  they  make 
for  her? 

12.  What  grade  in  school  did  she  reach?  What  do  the  teachers  who  knew  her 
best  think  of  her?  In  what  studies  did  she  excel?  What  vocational  training,  if 
any,  did  she  receive? 

13.  What  do  her  employers  say  of  her  work?  How  long  has  she  held  her  positions? 
If  she  was  employed  in  a  factory,  how  much  judgment  did  her  work  call  for? 
Was  it  mechanical?  If  as  a  domestic,  what  are  the  things  that  she  does  well, 
what  ill?  For  instance,  can  she  make  good  bread,  season  vegetables?  Is  she 
neat  and  clean  about  her  person  and  her  work?  Can  she  wash  and  iron?  Does 
she  wait  on  table  smoothly  and  quietly?  Has  she  done  ordering  for  her  mistress? 
How  much  did  she  know  when  her  mistress  took  her?  Does  she  improve — rap¬ 
idly  or  slowly?  Does  she  remember  directions,  or  do  they  have  to  be  repeated? 
What  does  she  do  best,  heavy  work  or  light?  Is  she  good  with  children?  Is  she 
capable  enough  to  hold  a  place  with  her  child? 

415 


SOCIAL  DIAGNOSIS 


14.  What  do  her  employers  say  of  her  character?  Is  she  honest,  of  a  good  dis¬ 
position,  industrious?  If  a  domestic,  has  she  been  discreet  with  tradesmen  who 
come  to  the  house?  Has  she  had  men  callers,  one  or  many?  Have  they  been 
accustomed  to  go  at  a  proper  hour?  Has  she  been  given  to  staying  out  very 
late?  Does  she  dress  conspicuously? 

15.  When  did  girl’s  or  woman’s  sexual  experience  begin?  Under  what  circum¬ 
stances — was  it  with  a  relative,  an  employer,  an  older  man,  a  school  boy?  Has 
she  accepted  money  from  any  man  or  men  for  unchastity,  or  has  she  received 
only  a  good  time — theaters,  dinners,  etc. — or  board?  Has  she  lived  for  any 
period  as  the  wife  of  any  man  or  men?  Has  she  supplemented  her  income  through 
men,  or  has  she  made  her  whole  livelihood  in  this  way?  If  so,  for  how  long  and 
when?  Has  she  been  a  common  prostitute,  has  she  had  a  succession  of  "friends,” 
or  has  she  been  intimate  with  but  the  one  man?  Has  she  a  court  record?*  From 
what  she,  her  relatives,  friends,  and  employers  say,  does  she  seem  to  seek  wrong¬ 
doing,  or  does  she  merely  yield  when  evil  approaches  her? 

16.  Has  she  had  another  child  or  other  children  by  a  different  man  or  men?  When 
were  the  children  born  and  where?  How  long  did  she  nurse  them?  If  they  did 
not  live,  at  what  age  and  of  what  disease  did  they  die?  If  they  are  alive,  where 
are  they — with  her,  with  her  family,  with  the  man’s  family,  boarded  out,  or 
adopted?  If  the  latter,  through  whom  was  the  adoption  brought  about?  What 
does  she  know  of  the  character  and  circumstances  of  the  adoptive  parents  of  her 
child  or  children?  Has  she  any  child  in  charge  of  a  society  or  institution?  Was 
it  placed  out  in  a  family?  How  often  has  its  mother  seen  it?  Is  it  under  super¬ 
vision?  If  she  separated  from  her  child,  what  has  seemed  to  be  the  effect  upon 
her  character?  If  she  kept  it  with  her,  what? 

17.  Has  she  ever  been  under  treatment  for  syphilis  or  gonorrhea?  When  and  by 
whom? 

II  The  Father1 

His  family 

18.  What  is  or  was  the  standing  of  the  man’s  parents  in  the  community?  Did  the 
father  instruct  his  sons  in  sex  hygiene?  Did  his  influence  in  this  direction  tend 
towards  high-mindedness,  towards  cautiousness  in  pleasure,  or  towards  un¬ 
abashed  laxity  in  morals?  Did  the  mother  and  sisters  take  a  double  standard 
for  granted?  (See  in  addition  same  topic  under  The  Mother  for  questions  that 
apply.) 

His  community 

19.  What  is  the  character  of  the  community  in  which  the  man  grew  up?  (See 
same  topic  under  The  Mother  for  questions  that  apply.) 

The  man  himself 

20.  Was  he  troublesome  to  his  parents  as  a  boy?  Respectful  and  obedient,  or  the 
reverse?.  What  sort  of  associates  did  he  have  while  he  was  growing  up?  How 
have  they  turned  out  morally?  Have  any  of  them  got  girls  into  trouble?  If  so, 

1  To  be  used  only  in  cases  where  the  mother  is  sure  who  is  the  father  of  her  child. 

416 


THE  UNMARRIED  MOTHER 


do  they  boast  of  it,  or  have  they  the  average  moral  scruples?  Where  do  they 
draw  the  line  as  to  the  things  “a  fellow  can’t  do”? 

21.  Did  he  spend  any  part  of  his  childhood  in  an  institution?  If  so,  how  long  was 
he  there,  at  what  age,  and  why?  What  was  his  record  while  there? 

22.  What  grade  in  school  did  he  reach?  Why  did  he  leave,  and  at  what  age? 

What  have  his  teachers  to  say  of  his  character  and  ability?  In  what  studies  did  > 

he  excel?  Has  he  attended  a  trade  school  or  a  night  school? 

23.  Is  he  single  or  married?  Is  he  still  living  at  home?  If  not,  at  what  age  and 
for  what  reason  did  he  leave?  How  has  he  lived  since?  What  type  of  associates 
has  he  chosen? 

24.  At  what  age  did  he  first  go  to  work?  With  what  employer  and  at  what  occupa¬ 
tion  has  he  worked  longest?  Where  is  he  now  working  and  how  long  has  he  held 
this  place?  What  do  his  employers  say  of  the  quality  of  his  work?  How  much 
judgment  does  it  call  for? 

25.  Does  he  drink  to  the  point  of  intemperance?  Use  drugs?  Gamble?  Is 
there  any  evidence  that  he  has  been  dishonest? 

26.  What  is  his  record  as  to  sexual  morality?  Has  he  been  known  as  a  loose  liver? 

Involved  in  scandals?  Or  has  he,  on  the  other  hand,  borne  a  good  reputation,  and 
is  this  the  first  affair  with  a  woman  in  which  he  has  been  involved? 

27.  Has  he  ever  been  arrested?  At  what  age  and  for  what  offense?  If  imprisoned, 
for  how  long?  What  was  his  record  at  reform  school  or  prison?* 

28.  Is  he  of  the  same  social  status  as  the  mother  of  his  child? 

III  The  Situation,  Past  and  Present 

Man  and  woman  ^ 

29.  What  is  the  girl’s  or  woman’s  explanation  of  her  going  wrong?  Was  she  en-  ' 
gaged  to  the  man?  Was  she  in  love  with  him?  If  not,  was  it  loneliness,  drink, 
ignorance,  force,  that  led  to  her  shame?  Where  and  when  did  she  meet  the  man? 

Was  she  living  at  home  at  the  time?  With  relatives,  friends,  in  a  lodging  house, 
or  at  service?  Had  she  known  the  man  steadily  or  was  he  a  passing  acquaint¬ 
ance?  Did  she  live  with  him  for  any  time  as  his  wife?  Did  he  promise  mar¬ 
riage?  Do  her  family  or  friends  know  of  his  seeing  her  often  at  about  the  time 
of  conception?  Had  they  been  expecting  that  he  would  marry  her?  Has  she 
letters  from  him  that  go  to  show  his  probable  paternity?  Has  the  man  known 
her  family,  called  at  her  home?  Does  she  know  his  family? 

30.  Does  the  man  acknowledge  paternity?  Does  he  acknowledge  having  had  rela¬ 
tions  with  her?  Does  he  claim  that  others  had  also?  If  so,  who?  Did  she  live 
in  a  lodging  house,  or  were  there  men  lodgers  in  the  same  house  or  tenement? 

Is  there  any  evidence  that  she  was  intimate  with  any  other  man  at  about  the  time 
of  conception?  Any  evidence  (such  as  that  of  the  physician  who  confined  her, 
regarding  earlier  abortions,  miscarriages,  or  births)  to  prove  her  previous  un¬ 
chastity? 

27 


417 


SOCIAL  DIAGNOSIS 


31.  What  is  the  man’s  opinion  of  the  girl’s  character?  What  suggestions,  if  any, 
has  he  made  to  her  regarding  her  plans?  Did  he  suggest  her  consulting  any 
illegal  practitioner?  Did  she  follow  his  advice?  Name  of  the  practitioner? 

32.  Do  the  man  and  the  girl  wish  to  marry?  If  so,  why  have  they  not  done  it 
before?  Are  they  both  such  human  material  as  to  make  marriage  advisable? 
What  are  the  man’s  health  and  habits?  Has  he  had  a  medical  examination? 
By  whom?  Was  it  clinical  only  or  with  laboratory  tests?  Does  marriage  in  the 
mother’s  home  state  legitimize  a  child,  or  must  its  parents  adopt  it? 

33.  Have  the  couple  lived  together  for  several  years  and  had  more  than  one  child? 
(Consult,  as  circumstances  of  the  case  demand,  the  questionnaires  regarding 
Any  Family,  a  Deserted  Family,  or  a  Neglected  Child,  pp.  378,  395,  and  405.) 

34.  If  the  man  is  married,  does  his  wife  know  of  his  relations  with  the  girl  or  woman? 
Has  he  legitimate  children  to  support?  If  unmarried,  has  he  relatives  whom  he 
must  help? 

35.  Has  the  man  property?  Flas  he  a  steady  place?  What  is  his  income?  Would 
his  employers  bring  pressure  on  him  to  help  his  baby,  or  would  they  abet  him  in 
eluding  his  responsibility?  Is  he  a  man  who  would  readily  leave  for  another 
state  if  prosecuted?  (See  Deserted  Family  Questionnaire,  p.  395.)  How  much 
should  he  pay? 

36.  Is  there  evidence  beyond  a  reasonable  doubt  as  to  man’s  paternity?  Has  he  a 
lawyer?  If  so,  who?  Will  the  man  settle  out  of  court?  Is  it  desirable  that  he 
do  so?  Why?  Can  he  get  bonds?  If  not,  is  he  likely  to  keep  up  weekly  pay¬ 
ments,  or  is  he  so  unreliable  that  a  lump  sum  is  wiser?  Would  his  family  do  any¬ 
thing  for  the  baby?  Has  his  father  property? 

37.  Has  the  mother  a  lawyer?  If  so,  who?  Has  she  taken  out  a  warrant,  started 
or  completed  proceedings?  If  the  latter,  what  was  the  settlement?*  Has  the 
man  paid  her  anything  towards  the  expenses  of  confinement,  etc.?  Did  she  sign 
a  release  paper?  Is  it  legally  valid?  If  she  has  taken  no  steps  against  the  man, 
does  she  wish  to  prosecute?  If  not,  is  this  a  case  in  which  it  is  advisable  for  an 
outside  party  to  bring  suit,  supposing  state  law  permits? 

38.  Is  it  better  that  the  man  pay  the  money  to  the  girl,  or  to  a  trustee  who  would 
hold  it  for  the  child?  In  your  opinion,  is  the  purpose  of  payment  in  this  case  to 
punish  the  man,  to  help  the  girl,  or  to  provide  for  the  baby’s  future? 

Mother  and  child 

39.  If  this  is  the  girl’s  or  woman’s  first  child,  does  she  appreciate  the  seriousness  of 
her  act  and  of  its  consequences?  Did  she  leave  her  home  to  hide  her  shame? 
To  give  her  baby  to  strangers  so  that  her  misconduct  might  remain  unsuspected 
at  home?  Does  she  love  her  baby?  Does  she  want  to  keep  it? 

40.  What  preparations  did  she  make  for  the  child?  How  long  before  confinement 
did  she  stop  work?  What  sort  of  work  was  she  doing  during  the  previous 
months?  What  was  her  physical  condition  at  this  time?  Did  she  have  instruc¬ 
tion  in  prenatal  care  and  did  she  follow  it? 

418 


the  unmarried  mother 


41.  Was  she  confined  in  a  hospital?  How  long  did  she  stay?  Did  she  receive  after¬ 
care?  If  not  confined  in  a  hospital,  where?  Was  she  attended  by  a  physician 

or  by  a  midwife?  (Name  and  address  of  either.)  How  soon  after  confinement 
did  she  go  to  work? 

42.  Is  the  child’s  birth  correctly  recorded?*  Has  the  child  been  baptized? 

43.  Have  the  mother  and  her  baby  been  examined  by  a  physician?  What  is  his 
name  and  address?  How  soon  after  confinement  did  the  examination  take 
place?  Was  it  clinical  only  or  was  it  accompanied  by  laboratory  tests?  Is  the 
mother  or  her  child  under  treatment?  What  is  the  physician’s  report  of  her 
health  and  of  the  child’s,  and  what  is  his  advice? 

44-  Does  she  nurse  the  baby?  If  not,  is  it  by  a  doctor’s  advice?  Can  she  get  pure 
milk?  Does  she  understand  the  preparation  of  food?  Has  she  had  instruction 
in  the  general  care  of  an  infant?  Is  she  capable  of  profiting  by  such  instruction? 
Can  she  easily  get  a  nurse’s  visits,  or  take  the  baby  to  a  clinic? 

45.  Do  her  parents  know  of  her  situation?  Are  they  so  circumstanced  that  they 
can  help  her  by  taking  her  home  with  the  baby,  by  tending  the  baby  while  she 
goes  to  work,  by  adopting  the  child,  or  by  showing  their  sense  of  responsibility 

m  any  other  way?  Do  they  feel  that  their  younger  children  should  be  kept  in 
ignorance  of  her  story? 

46.  What  are  the  unmarried  mother’s  plans  for  herself  and  child? 


419 


CHAPTER  XXV 


THE  BLIND 

THE  social  worker  may  happen  upon  cases  in  which  blind¬ 
ness  is  the  dominant  cause  of  the  present  situation,  or  he 
may  happen  upon  any  of  the  forms  of  disability  outlined  in 
other  questionnaires,  complicated  by  the  factor  of  blindness.  In 
the  latter  case,  sets  of  questions  like  that  regarding  a  Neglected 
Child,  or  a  Child  Possibly  Feeble-minded,  may  be  even  more  help¬ 
ful  than  one  on  blindness.  There  are,  however,  five  captions  under 
which  special  consideration  of  the  causes  and  results  of  blindness 
may  be  of  service.  In  making  the  questionnaire  regarding  a 
Blind  Person  given  in  this  chapter,  Miss  Lucy  Wright  has  arranged 
her  material  under  these  heads — prevention  of  blindness  and  con¬ 
servation  of  eyesight,  special  education,  special  employment,  spe¬ 
cial  relief,  and  recreation. 

Failure  to  be  of  practical  service  to  the  individual  in  cases  of 
blindness  is  usually  due  to  one  of  two  dangers — the  Scylla  and 
Charybdis  of  work  for  the  blind.  The  one  is  the  danger  of  over¬ 
estimating  the  chances  for  an  individual  by  considering  the  factor 
of  blindness  alone.  Other  handicaps — mental,  moral,  physical — 
are  of  even  greater  significance  in  the  struggle  of  the  blind  individ¬ 
ual  than  in  the  case  of  the  sighted.  On  the  other  hand,  the  failure 
may  be  due  to  underestimating  the  chances  for  the  individual 
because,  through  inexperience,  insufficient  trust  is  placed  in  the 
truly  great  possibilities  of  practical  accomplishment,  manual  and 
intellectual,  through  the  use  of  other  senses.  In  some  instances 
mental  and  moral  force  seems  to  gain  strength  under  what  appears 
the  great  disadvantage  of  working  in  physical  darkness.  As 
Norman  Duncan  makes  Tom  Tulk,  the  blind  skipper,  say,  “A  man, 
with  the  best  of  a  bad  job  to  make  .  .  .  will  learn  many  sur¬ 

prisin’  things  ...  by  means  of  all  the  little  voices  in  the 
world,  says  he,  which  speak  to  a  man  without  eyes.” 

420 


THE  BLIND 


QUESTIONNAIRE  REGARDING  A  BLIND  PERSON1 

This  is  not  a  schedule  to  be  filled  out  nor  a  set  of  queries  to  be  answered  by  a 
social  agency’s  client  or  clients.  For  an  explanation  of  the  purpose  of  these  ques¬ 
tionnaires  see  p.  373  sq. 

A  star  (*)  indicates  that  the  answer  to  the  question  may  be  found  in,  or  confirmed 
by,  public  records. 

I  Prevention  of  Blindness  and  Conservation  of  Eyesight 

1.  Has  a  physician,  expert  in  eye  diseases,  been  consulted? 

2.  Has  the  vision  of  each  eye  been  recorded  separately,  with  degree  of  vision,  cause 
of  blindness,  and  age  at  occurrence  of  blindness  for  each  eye? 

3.  Does  your  case  record  distinguish  clearly  between  patient’s  understanding  of 
cause  and  physician’s  statement  of  cause  of  blindness? 

4.  Was  the  cause  of  blindness  congenital  disease  or  defect,  acquired  disease,  or 
accident? 

5.  If  a  local  eye  defect,  can  it  be  helped  by  eye  glasses,  operation,  or  continuous 
treatment? 

6.  If  congenital  or  acquired  disease,  is  it  due  to  general  disintegrating  trouble 
which  may  need  continuous  treatment  or  result  in  other  complications?  Are 
there  chances  of  improvement  in  sight  if  general  treatment  is  followed? 

7.  If  accident,  was  the  accident  the  fault  of  the  individual,  the  occupation,  or  the 
community?  Is  there  anything  to  be  done  about  it  for  the  future  safety  of 
others?  If  industrial  accident,  has  compensation  been  allowed  the  individual? 

8.  Are  there  chances  of  retaining  the  remaining  degree  of  vision  if  the  right  occupa¬ 
tion  is  followed?  If  anxiety  about  support  of  self  or  family  is  relieved?  If 
healthful  life  is  made  possible? 

9.  Are  there  other  cases  of  blindness  or  eye  defect  in  family? 

10.  Is  the  disease  of  a  kind  which  may  in  active  stages  menace  other  members  of 
family  or  fellow  workers? 

1 1.  Although  not  blind,  has  the  patient  seriously  defective  eyesight,  even  with  the 
aid  of  the  best  glasses  obtainable?  When  was  he  first  given  glasses,  and  where? 
Subsequent  glasses  given  by  whom,  and  where?  Which  glasses,  if  any,  is  he  wear¬ 
ing  now?  Of  what  value  have  glasses  proved?  How  recently  has  he  had  a  physi¬ 
cian’s  advice  about  his  eyes? 

II  Appearance  and  Amount  of  Useful  Vision 

12.  Does  the  patient  need  to  wear  smoked  glasses  for  appearance’s  sake?  Would 
this  make  a  difference  about  his  getting  work? 

13.  Is  the  patient  totally  blind — or  at  most,  does  he  see  light  only? 

14.  Has  he  sufficient  sight  to  avoid  running  into  objects? 

1  Prepared  for  this  volume  by  Miss  Lucy  Wright,  General  Superintendent  of 
the  Massachusetts  Commission  for  the  Blind. 


SOCIAL  DIAGNOSIS 


15.  Is  he  able  to  distinguish  color  and  see  to  play  cards  but  not  able  to  read? 

16.  Is  he  able  to  see  to  read,  but  forbidden  to  use  his  sight  long  enough  for  that 

purpose? 

17.  Is  his  limitation  of  vision  or  of  use  to  which  it  can  be  put  sufficient  to  interfere 
with  ordinary  schooling  or  occupation? 

III  Special  Education — Children 

18.  What  is  the  developmental  history  of  the  child?  (See  questionnaire  regarding 
a  Child  Possibly  Feeble-minded,  p.  441.) 

19.  Does  the  child  appear  to  be  mentally  deficient?  May  this  appearance  be  due 
to  neglect  superadded  to  the  physical  defect?  Because  of  the  effect  of  such 
neglect,  should  not  the  child’s  special  education,  whether  at  home,  at  a  nursery, 
or  at  school,  begin  at  once  or  at  an  earlier  age  than  that  at  which  it  would  be 
necessary  to  begin  the  education  of  a  normal  child?  If  the  child  has  not  learned 
to  walk,  do  his  parents  realize  that,  while  he  may  walk  as  early  as  a  sighted  child, 
he  probably  needs  special  incentives  because  he  cannot  see  and  imitate?  If  he 
has  “habit  motions,”  putting  fingers  in  eyes  or  the  like,  do  the  parents  realize 
that  he  may  be  cured  of  them  if  taken  in  hand  early  enough?  Do  they  realize 
that  his  future  depends  upon  good  use  of  hands,  and  that  it  will  help  him  to  learn 
early  to  dress  and  feed  himself? 

20.  If  his  parents  refuse  at  first  to  let  him  go  away  from  home  to  school  and  there 
is  no  compulsory  education  law  which  is  effective  in  the  case  of  the  physically 
handicapped,  can  they  be  persuaded  to  visit  the  special  school  themselves  to  see 
its  advantages?  Can  a  blind  graduate  be  found  to  persuade  them?  If  there  is 
no  special  school,  can  public  school  training  with  sighted  children  be  supple¬ 
mented  by  special  teaching  from  some  trained  blind  person  in  the  neighborhood? 
Is  there  a  kindergarten  (worthy  of  being  attended)  which  can  be  made  use  of 
for  him? 

21.  If  the  child  is  at  a  special  school,  is  every  effort  being  made  to  keep  the  family 
and  friends  in  touch  with  the  child  and  the  school  in  order  that  a  recognized  place 
of  usefulness  may  be  ready  for  him  when  he  leaves  school? 

\ 

22.  If  the  blind  child  is  at  home,  is  he  being  spoiled  with  kindness  by  family,  neigh¬ 
bors,  and  sighted  school  mates,  or  is  he  having  his  chance  to  find  out  about  life 
as  it  is?  Does  he  do  his  share  of  errands,  fill  the  wood-box,  etc.? 

23.  Does  the  blind  child  have  his  share  of  play  and  contribute  to  pleasure  of  others, 
read  aloud  (from  some  form  of  Braille)  as  well  as  be  read  to? 

IV  Special  Education — Adults 

24.  If  there  are  no  travelling  home  teachers  for  adults  nor  any  special  school,  can 
some  teacher  (preferably  blind)  be  found  who  will  instruct  and  encourage  the 
newly  blind  person,  so  that  he  may  gain  confidence  in  other  senses — learn  to 
move  about  freely,  be  independent  by  use  of  some  one  of  the  forms  of  Braille, 
the  typewriter,  etc.? 


422 


THE  BLIND 


25.  Has  he  established  his  own  confidence  in  the  sense  of  touch  and  hearing  by  fol¬ 
lowing  normal  activities?  If  an  able-bodied  man  dependent  on  his  wife’s  earn¬ 
ings,  do  he  and  she  realize  that  he  can  help  with  housework,  saw  wood,  etc.,  while 
he  is  waiting  for  the  chance  to  learn  a  new  trade? 

26.  Can  he  recall  any  part  of  his  occupation  as  a  sighted  man  which  he  came  in¬ 
stinctively  to  do  by  touch  or  in  which  his  hearing  aided  him?  Is  there  any  part 
of  the  process  which  he  could  still  do? 

27.  Has  he  sufficient  executive  ability  to  carry  out  a  small  venture  of  his  own,  like 
a  news-stand,  or  does  he  need  to  work  for  someone  else? 

28.  Could  he  compete  without  further  aid  if  his  chances  with  sighted  workers  are 
equalized  by  his  learning  a  new  trade,  such  as  broom-making;  if  adequate  pro¬ 
vision  is  made  for  a  guide;  if  provision  is  made  for  transcribing  his  music  into 
Braille;  if  he  has  aid  in  marketing  products;  if  any  other  extra  expenses  incident 
to  his  blindness  are  provided  for? 

29.  If  he  cannot  work  in  competition  with  the  sighted,  either  in  a  shop  or  in  an  in¬ 
dependent  enterprise,  is  he  strong  enough  nervously  for  a  full  day’s  work  in  a  sub¬ 
sidized  shop?  For  a  heavy  day’s  work  such  as  broom-making  or  other  occupa¬ 
tion  entails? 

30.  Had  he  any  important  hobbies,  such  as  chicken  raising,  cabinet  work,  or  bas¬ 
ketry,  before  loss  of  sight?  Does  he  know  this  hobby  well  enough  to  pursue  it 
under  handicap,  effectively  and  with  courage?  Can  he  be  given  supplementary 
training  in  this  direction?  Can  you  consult  some  blind  person  who  has  worked 
out  an  occupation  for  himself  under  similar  circumstances? 

31.  If  home  industry  is  possible,  can  adequate  supervision  be  provided? 

32.  Have  you,  before  trying  to  market  products,  considered  that  great  as  is  sym¬ 
pathy  for  the  blind,  when  it  comes  to  business,  their  goods  must  be  not  only  “as 
good  as”  but  “better  than”  like  products  of  the  sighted?  Does  the  blind  worker 
realize  that  poor  work  means  a  forced,  temporary  market,  good  work  a  steady, 
permanent  market? 

V  Special  Relief  for  Blind  as  Such 

33.  Is  the  blindness  in  any  way  the  fault  of  the  community,  i.  e.,  industrial  acci¬ 
dent,  industrial  disease?  Or  is  it,  as  with  many  other  troubles,  the  fault  of 
nature,  disease,  or  accident  not  preventable  with  knowledge  as  it  stands  today? 
Or  the  fault  of  the  individual,  needlessly  acquired  disease,  or  accident  through 
carelessness? 

34.  Has  the  blind  individual  contributed  to  his  family  and  to  society  in  proportion 
to  his  ability?  Before  his  blindness?  How?  Since  his  blindness?  How? 

35.  If  the  blind  individual  is  dependent,  in  what  proportion  is  his  dependence  due 
to  lack  of  natural  endowments  other  than  sight?  To  lack  of  preparation  for 
competition;  that  is,  no  special  education,  or  lack  of  other  resources  for  blind? 
To  presence  of  social  and  industrial  obstacles  common  to  others  than  the  blind? 

423 


SOCIAL  DIAGNOSIS 


36.  If  institutional  care  is  asked,  is  it  for  the  protection  of  the  blind  individual,  for 
the  protection  of  the  community,  or  for  the  convenience  or  saving  of  expense  to 
relatives? 


37.  Should  the  blind  individual’s  economic  situation  be  considered  alone  or  in  re¬ 
lation  to  that  of  his  near  relatives?  How  near  are  these  relatives?  What  is 
their  ability,  financial  or  other,  to  care  for  him? 

38.  If  special  forms  of  relief  are  sought  or  needed  differing  from  or  in  excess  of 
relief  received  by  citizens  otherwise  handicapped,  what  shall  be  required  of 
him  in  return  for  such  relief?  Work?  Reasonable  standards  of  living  and 
conduct? 


39.  Did  the  individual  become  blind  after  sixty?  Had  he  been  successful  or  had  he 
failed  while  in  possession  of  his  sight?  Is  his  problem  really  a  problem  of  blind¬ 
ness? 


VI  Recreation 

40.  Are  there  not  resources  for  recreation  for  sighted  persons  that  this  blind  person 
could  make  use  of?  If  he  is  not  using  them,  what  stands  in  the  way  and  how 
may  the  difficulty  be  overcome?  Is  it  lack  of  a  guide?  Is  it  inability  to  provide 
for  double  expense  of  carfares,  etc.?  Or  lack  of  encouragement  from  family? 
Or  needless  sensitiveness? 

41.  Can  the  family  or  friends  be  led  to  encourage  him  to  all  possible  normal  activi¬ 
ties,  walks,  church,  music,  theater? 

42.  If  he  minds  being  done  for,  can  you  not  arrange  for  him  to  do  something  for 
somebody  else,  read  aloud  from  Braille,  etc.,  at  least  do  things  with  others? 

43.  Does  he  realize  that  bowling,  dancing,  swimming,  football,  and  gardening  are 
parts  of  the  training  and  play  at  schools  for  the  blind?  Can  any  opportunity  for 
him  to  practice  any  of  these  exercises  or  games,  or  others  that  will  take  their 
place,  be  developed? 


44.  Can  a  friendly  visitor  (sighted)  be  found  who  will  call  and  converse  (be  talked 
to  as  well  as  talk)?  Does  this  visitor  realize  that  automobile  rides,  carriage  rides, 
street  car  rides,  or  a  walk  will  give  respite  to  the  family  of  a  blind  invalid  as  well 
as  prove  a  tonic  to  the  invalid  himself? 


CHAPTER  XXVI 

THE  HOMELESS  MAN— THE  INEBRIATE 

THOUGH  these  two  subjects  overlap  at  one  point,  their  juxta¬ 
position  here  is  entirely  arbitrary.  The  inebriate  is  a  pa¬ 
tient  of  the  physician,  or  should  be;  the  homeless  man  is  a 
client  of  the  social  agency — often  in  need  of  medical  care,  it  is 
true,  but  presenting  no  one  medical  problem.  Inebriety  is  an 
important  topic  for  the  case  worker  because  the  inebriate  is  often 
in  need  not  only  of  medical  but  of  social  treatment,  and  for  the 
further  reason  that  he  is  often  given  a  type  of  social  treatment 
which  ignores  altogether  the  obvious  need  of  medical  co-operation. 

I.  THE  HOMELESS  MAN 

The  fact  of  homelessness  brings  under  this  one  caption  many 
different  sorts  of  men  and  boys,  from  the  lad  seeking  adventure 
and  the  seasonal  laborer  to  the  homeless  aged  and  the  confirmed 
wanderer  or  tramp.  Mrs.  Alice  Willard  Solenberger  has  described 
them  all  in  One  Thousand  Homeless  Men,  so  that  it  is  unnecessary 
to  do  more  here  than  to  refer  case  workers  to  that  book,  by  which 
some  of  the  questions  that  follow  were  suggested. 

HOMELESS  MAN  QUESTIONNAIRE 

This  is  not  a  schedule  to  be  filled  out  nor  a  set  of  queries  to  be  answered  by  a 
social  agency’s  client  or  clients.  For  an  explanation  of  the  purpose  of  these  ques¬ 
tionnaires  see  p.  373  sq. 

A  star  (*)  indicates  that  the  answer  to  the  question  may  be  found  in,  or  confirmed 
by,  public  records. 

I  Present  Situation 

i.  How  long  has  the  man  been  in  this  country,  state,  city?  If  foreign  born,  is  he 
thoroughly  Americanized?  Is  he  a  citizen? 

2.  Why  did  he  come  to  this  city?  From  what  place  did  he  last  come?  What  was 
his  address  there?  How  did  he  get  here?  Did  he  “beat”  his  way?  Was 
transportation  furnished  by  a  charitable  society,  an  individual,  an  employer,  or 
employment  agency? 

425 


SOCIAL  DIAGNOSIS 


3.  If  a  foreigner,  has  he  been  exploited  by  any  employment  agent,  foreign  banker, 
or  padrone?  Sent  to  this  city  or  state  on  false  promises  of  work,  or  discharged 
after  brief  service  contrary  to  contract  or  oral  agreement?  Do  the  ascertainable 
facts  in  the  case  furnish  a  basis  for  prosecution  under  any  state  or  federal  law? 

4.  Where  and  under  what  conditions  is  he  now  living — with  friends,  in  a  common 
lodging  house,  a  furnished  room,  or  how?  How  has  he  maintained  himself  since 
coming  to  the  city?  What  is  his  present  income,  if  any?  Has  he  money  in  his 
possession  or  due  him?  Does  he  receive  money  periodically:  if  so,  how  much 
and  from  what  sources?  Or  is  he  entirely  without  resources? 

5.  Has  he  had  a  home?  Where?  Has  he  been  away  from  it  long?  What  have 
been  his  wanderings?  In  what  places  has  he  stayed?  Length  of  stay,  address, 
manner  of  life  in  each?  Has  he  a  legal  residence  anywhere? 

II  Home  Life 

6.  What  were  the  conditions  of  his  early  home  life?  Were  his  parents  physically 
and  mentally  normal?  Did  they  fulfill  their  responsibilities?  What  was  his 
home  training?  Was  he  indulged  or  unduly  repressed? 

7.  Until  what  age  did  he  go  to  school?  Did  he  make  normal  progress?  If  not, 
why?  In  what  grade  was  he  when  he  left?  Why  did  he  leave?  Did  he  play 
truant  or  show  signs  of  a  roving  disposition  while  at  school?  Did  he  like  school? 
What  studies,  if  any,  did  he  enjoy  or  excel  in?  What  was  his  religious  educa¬ 
tion? 

8.  Did  he  spend  any  part  of  his  childhood  in  an  institution?  What  institution? 
Between  what  dates  was  he  there?  Why  was  he  placed  in  the  institution  and 
what  led  to  his  discharge?  What  sort  of  record  had  he  there? 

9.  What  were  his  amusements  in  childhood  and  youth?  What  sort  of  associates 
had  he? 

10.  After  he  began  to  work  did  he  turn  over  his  wages  to  his  family?  What  allow¬ 
ance  or  spending  money  did  he  receive? 

11.  If  he  is  married,  what  are  the  facts  about  his  wife  and  children?  How  old 
was  he  when  he  married?  How  old  was  his  wife?  What  was  he  earning  at  time 
of  marriage?  What  at  the  time  of  leaving  home?  What  sort  of  home  had  he? 
Were  he  and  his  wife  happy?  Was  he  fond  of  the  children?  What  reason  does 
he  give  for  having  left  home?  If  he  has  deserted,  is  this  the  first  time?  Has  he 
apparently  broken  away  for  good  or  is  this  a  temporary  desertion?  What  is  the 
date  of  his  last  letter  from  his  family?  (See  Deserted  Family  Questionnaire, 

P-  395-) 

12.  If  he  is  widowed,  when  did  his  wife  die?*  How  have  the  children  been  provided 
for  since?  When  did  he  last  see  them?  Did  he  begin  his  wanderings  at  time  of 
wife’s  death? 

13.  If  separated  or  divorced,  when  and  for  what  reasons?*  What  provision  was 
made  for  the  children? 

14.  If  single,  what  kind  of  home  had  he?  In  city  or  country?  Were  its  condi¬ 
tions  good  or  bad?  Were  both  parents  still  living?  Were  they  living  together? 

426 


THE  HOMELESS  MAN 


How  old  was  he  when  he  left  home?  Why  did  he  leave?  How  has  he  lived 
since  leaving  home?  What  is  his  attitude  toward  his  parents  and  other  mem¬ 
bers  of  his  immediate  family?  (If  a  runaway  boy,  a  frank  story  of  his  home 
conditions  and  of  the  incidents  which  led  to  his  running  away  should  be  sought.) 

15.  Has  your  agency  or  any  other  communicated  with  parents,  other  relatives,  or 
friends  in  his  home  town?  What  do  they  give  as  his  reason  for  leaving  home? 

III  Work  History 

16.  At  what  age  did  he  begin  work?  Was  he  ever  a  newsboy  or  messenger?  What 
was  the  nature  and  wage  of  first  occupation? 

17*  Did  he  learn  a  trade?  If  so,  why  did  he  give  it  up? 

18.  Does  he,  or  did  he  ever,  belong  to  a  trade  union?  If  his  membership  has  lapsed 
how  did  this  happen?  Does  he  attribute  later  failure  to  such  a  lapse,  or  feel  that 
to  become  a  union  member  would  put  him  on  his  feet?  Have  any  union  officials 
been  consulted  in  regard  to  his  past  record  or  possible  reinstatement,  or  in  regard 
to  obtaining  membership? 

iq-  Did  he  ever  serve  in  the  army  or  navy?  Between  what  dates?  What  were  the 
circumstances  of  his  discharge  and  his  record  in  the  service?* 

20.  Wrhat  have  been  his  various  occupations,  the  length  of  time  each  was  held,  the 
wage,  reasons  for  giving  it  up?  Have  his  former  employers  been  communicated 
with  to  verify  these  statements  and  to  learn  their  view  of  the  reasons  for  his  in¬ 
dustrial  failure? 

21.  W  hat  occupation  did  he  like  best,  and  why?  What  one  of  his  employers  did 
he  like  best,  and  why? 

22.  W^hat  was  the  longest  time  he  ever  held  a  job?  Which  job  was  it?  What  was 
the  highest  wage  he  ever  received? 

23.  What  was  his  last  occupation?  How  long  ago?  Wage?  How  did  he  lose  it? 
Is  his  work  casual,  irregular,  or  seasonal  by  nature?  How  has  he  previously 
lived  between  jobs? 

24.  W  as  his  chief  occupation  too  strenuous?  Did  he  have  to  work  too  long  hours? 
What  proof  is  there  that  he  was  not  physically  equal  to  it? 

25.  Has  he  ever  been  in  business?  What  was  it?  Did  he  ever  succeed?  Reason 
for  failure? 

26.  Could  he  now  go  back  to  any  of  his  old  jobs? 

27.  W^hat  effort  has  he  made  to  get  work  where  he  is?  With  what  success? 

28.  If  prevented  by  physical  handicaps  from  doing  the  work  that  he  is  accustomed 
to  do,  what  else  is  he,  or  can  he  be,  fitted  to  do? 

IV  Physical  and  Mental  Condition 

29.  W7hat  is  his  present  physical  and  mental  condition?  Has  this  been  verified  by 
medical  examination? 

30.  If  physically  handicapped,  what  is  the  nature  of  handicap?  Its  cause?  Is 
recovery  possible?  Will  any  special  treatment,  appliance,  or  course  of  training 
help  to  put  him  on  his  feet? 


427 


SOCIAL  DIAGNOSIS 


31.  If  the  handicap  is  due  to  accident,  when  did  accident  occur?  Where?  Under 
what  circumstances?  If  it  was  an  industrial  accident,  who  was  his  employer? 
What  settlement,  if  any,  was  made? 

32.  If  he  is  ill,  what  are  causes  ot  illness?  What  medical  care  is  necessary?  Is  he 
in  a  condition  that  is  a  menace  to  those  with  whom  he  works,  lives,  or  associates? 

33.  If  epileptic,  feeble-minded,  or  insane,  has  he  ever  had  any  institutional  care? 
Where?  When?  Has  the  institution  been  asked  for  an  account  of  him?  Is  he 
eligible  for  any  institution? 

34.  If  aged,  or  feeble,  what  is  his  attitude  toward  almshouse  care?  Or  (if  his  case 
is  suitable)  toward  care  in  a  private  institution? 

V  Moral  and  Intellectual  Status 

35.  What  vices,  if  any,  has  he?  Is  he  a  gambler  or  given  to  betting?  Does  he 
drink  moderately  or  to  excess?  When  did  he  begin  to  drink,  while  very  young  or 
after  reaching  manhood?  Does  he  use  tobacco  in  any  form  to  excess?  Drugs? 
Has  he  ever  taken  any  drug  or  liquor  cure?  Has  he  ever  been  in  any  institution 
for  the  care  of  inebriates?  (See  Inebriety  Questionnaire,  p.  430.) 

36.  Has  he  ever  been  arrested?  For  what  offense?*  What  was  the  sentence?* 
If  imprisoned,  what  were  the  dates  of  commitment  and  release?*  Has  the  prison 
or  reform  school  been  asked  for  an  account  of  him? 

37.  Has  he,  or  has  he  ever  had,  any  religious  affiliation?  Has  his  family?  What 
is  his  attitude  toward  religion? 

38.  Is  he  discouraged?  What  is  the  thing  that  especially  discourages  him? 

39.  Is  there  anything  in  his  temperament  which  explains  his  past  failures? 

40.  Does  he  really  desire  a  chance  to  get  on  his  own  feet  and  turn  his  back  on  his 
present  way  of  living? 

41.  Does  he  read  much  and  what  does  he  prefer  to  read? 

42.  What  are  his  ideas  about  education,  about  politics,  about  capital  and  labor, 
about  social  conditions?  Does  he  believe  in  a  democracy,  and  under  what  form 
of  government  would  he  prefer  to  live? 

VI  Plans  for  the  Future 

43.  What  relatives  has  he?  What  is  their  ability  to  help  or  advise? 

44.  What  other  possible  sources  of  assistance — former  employers,  charities  inter¬ 
ested,  etc. — are  there? 

45.  What  are  his  own  plans  for  the  future?  What  is  his  attitude  toward  work? 
Toward  institutional  care? 

46.  If  he  has  a  home  town  with  normal  environment  and  influences,  is  he  willing 
to  return  to  it?  If  so,  would  anyone  there  take  an  interest  in  him? 

47.  What  does  he  look  back  upon  as  his  best  period?  What  marks  of  it  still  re¬ 
main,  such  as  personal  cleanliness,  for  example?  Can  its  conditions  be  won  back? 


428 


THE  INEBRIATE 


II.  THE  INEBRIATE 

This  word  has  come  to  have  a  more  definite  meaning  than  for¬ 
merly.  1 1  has  never  applied  to  all  who  drink,  nor  does  it  apply  now 
to  all  who  get  drunk;  it  does  apply,  however,  to  all  who,  owing  to 
a  constitutional  peculiarity  or  defect,  are  habitually  overcome  by 
alcohol  and  unable  to  take  it  at  all  without  taking  it  to  excess. 
Inebriety  is  a  disease.  It  requires  skilful  medical  diagnosis— a 
diagnosis  which  includes  both  a  general  physical  examination  and 
a  mental  examination  of  the  patient.  The  disease  is  not  curable 
in  the  sense  that  one  who  has  once  suffered  from  it  can  ever  trust 
himself  even  to  taste  alcohol  without  danger  of  a  relapse.  An 
important  further  fact  for  the  social  worker  to  know  is  that  both 
the  medical  and  the  social  treatment  of  the  disease  achieve  a  far 
larger  measure  of  success  if  the  malady  is  dealt  with  when  its 
manifestations  first  appear.  “Other  things  being  equal/'  says 
R.  W.  Branthwaite,  “the  success  or  failure  of  treatment  depends 
largely  upon  the  early  application  of  remedial  measures.”1  If 
possible,  prompt  resort  should  be  had  to  a  physician  specially 
skilled  in  dealing  with  this  particular  disability,  and  in  distinguish¬ 
ing  it  from  the  alcoholic  excess  of  those  who  still  have  the  power  of 
will  to  remain  sober  if  they  choose  to  exercise  it.  Alcoholic  excess 
may  be  due,  moreover,  to  some  removable  physical  cause,  or  it 
may  be  an  outcropping  of  mental  disease  or  of  mental  defect. 

We  now  say  the  “patient”  and  not  the  culprit,  be  it  noted. 
The  earliest  draft  of  this  questionnaire  referred  to  the  inebriate 
as  desiring  to  reform,  as  having  reformed,  or  as  possibly  being 
helped  to  do  so  by  a  “reformed  drunkard.”  This  is  not  the 
language  that  we  can  use  or  the  position  that  we  can  take  in  the 
light  of  recent  scientific  discovery.  It  is  true  that  no  improve¬ 
ment  in  the  inebriate's  condition  is  possible  until  some  personal 
influence  or  some  new  set  of  circumstances  has  made  a  sufficient 
impression  upon  his  mind  to  give  him  a  strong  desire  to  win  the 
necessary  self-control.  In  varying  degree,  success  in  the  treat¬ 
ment  of  tuberculosis  and  of  a  dozen  other  diseases  depends  upon 
the  patient's  co-operation,  but  individualization  and  long  con¬ 
tinued  personal  interest  seem  to  be  peculiarly  needed  with  this 

1  Report  of  the  Inspector  under  the  Inebriates  Act,  1909. 

429 


SOCIAL  DIAGNOSIS 


disability.  Hence  social  work  has  an  important  part  to  play,  first 
in  gathering  the  pertinent  social  data,  and  later  in  rallying  to  the 
patient’s  aid  every  tonic  influence  which  can  supplement  the  medi¬ 
cal  means  employed.  Social  work  must  be  continued  too  during 
the  long  period  of  after-care  which  is  usually  necessary. 

The  writer  is  indebted  for  valuable  suggestions  in  the  preparation 
of  the  following  questionnaire  to  Dr.  Irwin  H.  Neff,  of  the  Norfolk 
State  Hospital  in  Massachusetts,  and  for  the  point  of  view  ex¬ 
pressed  in  these  introductory  paragraphs  to  Dr.  Neff  and  to  the 
remarkable  report  of  Inspector  Branthwaite  already  quoted. 

INEBRIETY  QUESTIONNAIRE 

This  is  not  a  schedule  to  be  filled  out  nor  a  set  of  queries  to  be  answered  by  a 
social  agency’s  client  or  clients.  For  an  explanation  of  the  purpose  of  these  ques¬ 
tionnaires  see  p.  373  sq. 

A  star  (*)  indicates  that  the  answer  to  the  question  may  be  found  in,  or  confirmed 
by,  public  records. 

The  questionnaire  regarding  Any  Family  (p.  378)  precedes  this  one.  Its  more 
general  questions  are  repeated  here  only  in  rare  instances  when  it  has  seemed  neces¬ 
sary  to  give  them  special  emphasis. 

I  Heredity 

1.  What  were  the  habits  of  the  parents,  grandparents,  and  great-grandparents  in 
respect  to  alcohol  and  habit-forming  drugs  (opium,  morphine,  cocaine,  ether, 
chloral,  patent  medicines,  headache  powders,  etc.)?  What  are  the  habits,  in  these 
respects,  of  uncles  and  aunts,  of  brothers  and  sisters?  Wherever  any  relative 
mentioned  used  alcohol,  (1)  Was  his  use  of  it  strictly  moderate?  (2)  Was  he  a 
free  drinker  who  occasionally  got  drunk?  Or  (3)  was  he  unable  to  take  alcohol 
at  all  without  being  overcome  by  it?  If  either  parent  of  the  present  patient 
was  an  alcoholic  (2)  or  an  inebriate  (3),  did  these  habits  develop  before  the  birth 
of  the  patient? 

2.  Is  there  any  history  of  mental  or  of  nervous  trouble  in  the  family?  Were  any 
of  the  ancestors  and  relatives  mentioned  above  insane?  Did  any  commit  suicide? 
Were  any  feeble-minded?  Epileptic?  Did  any  have  “nervous  prostration,” 
or  “fits”?  Did  any  have  marked  eccentricities,  violent  temper,  periods  of  ex¬ 
treme  depression? 

II  Duration 

3.  How  long  has  patient  been  addicted  to  the  excessive  use  of  alcohol?  How  long 
has  he  noticed  that  he  has  been  unable  to  use  alcohol  socially  or  drink  in  modera¬ 
tion? 

4.  Longest  period  of  abstinence  previous  to  two  years  ago?  Longest  period  of 
abstinence  during  last  two  years? 


430 


THE  INEBRIATE 


III  Causal  Factors 

5.  What  is  the  patient’s  own  analysis  of  the  cause  or  causes  of  his  drinking?  What 
are  his  reasons  for  relapses  or  for  the  continuance  of  drinking  periods? 

6.  Is  he  nervously  unstable?  What  evidence  does  he  give  of  such  nervous  instabil¬ 
ity?  Has  this  condition  developed  recently  or  has  it  been  present  since  child¬ 
hood?  Is  there  reason  to  suspect  that  he  is  mentally  deficient?  (See  question¬ 
naire  regarding  a  Child  Possibly  Feeble-minded,  p.  441.) 

7.  Are  the  home  conditions  such  as  to  incline  him  to  seek  the  saloon  as  more  cheer¬ 
ful?  Is  the  home  situated  in  the  vicinity  of  saloons?  Is  it  squalid  and  in  dis¬ 
order?  Does  he  take  his  meals  at  home?  If  so,  are  they  well  cooked? 

8.  Has  he  been  unfortunate  in  business  or  family  affairs?  Has  he  suffered  from  any 
painful  disease  or  been  in  ill  health?  Has  he  suffered  any  severe  shock  or  loss 
which  unsettled  him  and  caused  him  to  turn  to  drink?  Is  he  happily  married? 
Is  his  wife  of  a  nagging  disposition,  or  has  she  any  bad  habits  that  make  trouble 
between  them?  Has  he  children,  and  if  so  are  they  of  good  health  and  habits? 

9.  Is  his  employment  such  as  to  expose  him  unduly  to  the  temptation  to  drink 
(brewery  worker,  teamster,  hack-driver,  bartender,  butler,  waiter,  longshore¬ 
man,  etc.)?  Does  he  work  long  hours  in  extremes  of  temperature?  Under 
trying  conditions  of  dust,  humidity,  or  bad  ventilation?  Does  he  get  drunk 
only  when  unemployed? 

10.  (For  a  woman)  Has  she  been  in  the  habit  of  using  alcoholic  liquors  every  month 
when  unwell?  Has  she  had  frequent  pregnancies?  Has  she  used  alcohol  to 
give  her  an  increased  supply  of  milk  for  nursing? 

IV  Drinking  Habits 

11.  Does  the  patient  have  something  to  drink  every  day  or  every  week?  Are 
there  periods  of  weeks  or  months  during  which  he  will  not  touch  alcohol,  which 
alternate  with  periods  of  complete  intoxication? 

12.  Does  he  do  most  of  his  drinking  in  the  saloon?  In  the  home?  With  other 
members  of  the  family?  Does  he  take  alcohol  in  the  morning  before  taking  food? 
Is  he  a  solitary  drinker;  that  is,  does  he  drink  only  when  off  by  himself?  If  in 
the  saloon,  does  he  buy  his  drinks  or  is  he  treated? 

13.  Has  he  any  drug  habit  in  addition  to  his  alcoholism?  Was  the  alcohol  habit 
acquired  as  a  substitute  for  any  drug  habit?  Have  drugs  been  used  to  promote 
or  encourage  “sobering  up”  from  drinking? 

14.  Does  he  desire  to  be  rid  of  his  alcohol  habit?  Is  he  indifferent  about  it?  Is  his 
attitude  antagonistic  on  this  subject?  If  the  first,  is  his  desire  due  to  a  mental 
antagonism  to  his  habit,  of  which  he  is  ashamed,  or  is  it  dependent  upon  the  need 
of  treatment  for  some  physical  disease  which  may  or  may  not  be  due  directly  to 
alcoholic  poisoning? 

V  Physical  Condition  and  Medical  Treatment 

15.  Has  he  ever  been  under  medical  treatment  for  the  alcohol  habit?  If  so,  what 
was  the  nature  of  the  treatment?  Was  he  treated  at  a  hospital?  How  long? 

431 


SOCIAL  DIAGNOSIS 


Did  he  leave  on  the  advice  and  with  the  consent  of  the  physician?  Did  he  co¬ 
operate  after  leaving  in  any  medical  after-care?  Did  he  undergo  treatment  at 
home? 

1 6.  With  regard  to  the  present,  has  patient  lost  weight?  Does  he  crave  food  regu¬ 
larly  and  is  his  appetite  good?  Does  he  sleep  well?  Has  he  any  physical  in¬ 
firmity? 

17.  Has  he  been  examined  recently  by  a  physician?  If  so,  what  was  his  report? 

18.  If  no  physician  has  been  consulted  about  patient’s  habit,  are  not  medical  advice 
and  treatment  needed  either  before  or  at  the  same  time  that  social  treatment 
begins?  Is  it  possible  to  secure  these  from  a  physician  who  is  especially  inter¬ 
ested  in  the  diagnosis  and  treatment  of  inebriety  on  both  the  physical  and  the 
mental  side?  Does  this  physician  advise  a  general  medical  examination  also? 

VI  Social  Conditions 

19.  Patient’s  exact  statement  in  detail  as  to  feeling  of  inefficiency  due  to  alcohol? 
Has  the  drink  habit  led  to  loss  of  work?  Has  unemployment  from  this  cause 
been  occasional?  Frequent?  Habitual?  Time  lost  from  work  during  last 
year?  Financial  loss  to  patient  and  family  during  this  period?  During  his  last 
three  drinking  bouts? 

20.  Is  the  patient  and  are  his  family  reduced  to  poverty  because  of  his  drink  habit? 

21.  Does  his  wife  have  to  work  to  help  support  the  family?  Are  the  children 
obliged  to  work  also? 

22.  If  his  work  is  steady,  is  he  paid  off  regularly  on  Saturday?  Does  he,  as  a  rule, 
turn  over  part  of  his  wages  to  his  wife  or  family?  If  so,  what  proportion  of  his 
wages? 

23.  Does  he  obtain  money  from  his  wife  or  children  to  buy  drink?  Does  he  ever 
pawn  household  articles  with  this  object  in  view? 

24.  Does  he  abuse  other  members  of  the  family  when  drunk?  When  sober? 

25.  Is  there  any  evidence  that  he  has  criminal  tendencies?  Do  these  criminal 
tendencies  antedate  his  drunkenness  or  do  they  occur  only  during  the  periods  of 
intoxication? 

VII  Social  Treatment 

26.  Has  there  ever  been  an  attempt,  apparently  successful,  to  make  the  patient  a 
total  abstainer,  and  under  what  circumstances? 

27.  Has  he  ever  been  arrested  for  drunkenness?*  If  so,  was  he  fined?*  Impris¬ 
oned?*  Released  on  probation?*  Has  he  been  repeatedly  arrested  for  this 
offense?*  Was  he  ever  sent  to  a  hospital  for  treatment  as  a  condition  of  proba¬ 
tion  or  suspended  sentence?* 

28.  Can  any  new  adjustment  be  made  in  the  home  which  will  help  him  to  recovery? 
What  will  win  the  co-operation  of  his  family  and  make  his  surroundings  more 
livable? 


432 


THE  INEBRIATE 


29.  Is  complete  change  of  environment  desirable  and  possible,  either  as  a  tempo¬ 
rary  measure  for  a  period  of  special  treatment  or  permanently?  Has  he  formed 
harmful  associations  with  which  his  connection  should  be  broken?  Are  there 
helpful  associations  which  could  be  formed — as  with  a  church  or  settlement  club 
or  with  an  individual  volunteer?  Could  anyone  formerly  a  drunkard  but  now 
an  abstainer  be  brought  to  take  an  active  personal  interest  in  him? 

30.  Has  he,  or  has  he  ever  had,  any  religious  affiliations?  Has  he  shown  himself 
susceptible  to  religious  influences?  Has  he  had  contact  with  churches,  missions, 
etc.?  What  is  his  attitude  toward  religion? 


28 


433 


CHAPTER  XXVII 


THE  INSANE— THE  FEEBLE-MINDED 

THESE  two  disabilities,  of  insanity  and  of  feeble-mindedness, 
carry  us  still  farther  than  that  of  inebriety  into  the  territory 
where  medical  and  social  data  are  not  easily  separated.  It 
cannot  be  too  emphatically  stated,  however,  that  the  question¬ 
naires  here  given  can  in  no  sense  enable  a  social  worker  to  make  a 
medical  diagnosis;  the  diagnosis  of  mental  disease  and  of  mental 
defect  must  be  regarded  always  as  primarily  medical,  though  social 
data  of  the  right  kind  can  suggest  the  need  of  a  physician  in  the 
first  place  and  may  be  serviceable  to  him  later  in  making  an  in¬ 
clusive  examination  of  his  patient. 

Insanity  is  a  term  describing  a  legal  rather  than  a  medical  con¬ 
cept.  It  is  loosely  applied  to  mental  disorders  differing  widely  in 
their  origins  and  in  their  manifestations.  Obviously  no  one  ques¬ 
tionnaire  would  be  equally  applicable  to  persons  suffering  from 
senile  mental  reduction,  those  exhibiting  undue  pressure  of 
mental  and  physical  activity,  and  those  in  whom  slow  distortions 
of  mental  life  are  taking  place.  From  the  alienist’s  point  of  view, 
the  present  outline  merely  suggests  general  lines  of  inquiry;  for 
the  social  worker,  however,  its  questions  are  not  routine  questions 
and  must  not  be  so  understood. 

The  social  worker  without  medical  training  is  sometimes  ill 
fitted  to  face  the  ugly  facts  of  defect  and  disease.  To  keep  his 
sense  of  values  keen  and  true,  his  must  be  a  spirit  of  sane  help¬ 
fulness.  No  one  has  described  the  right  attitude  better  than  Dr. 
Adolf  Meyer,  who,  five  years  ago,  sent  the  writer  the  following 
comments,  among  others,  in  criticising  a  discouraging  record  of 
social  work  with  a  family  of  defective  mentality. 

We  meet  here  a  very  difficult  problem.  As  far  as  I  can  see,  the  social  worker 
like  the  physician  must  learn  to  accept  human  nature  and  human  doings  as  they  are 
before  rushing  in  with  the  superior  knowledge  of  how  they  ought  to  be.  The  first 
need  is  to  know  what  they  are.  .  .  .  The  motto  of  every  social  worker  and  in- 

434 


THE  INSANE 


vestigator  must  be  that  of  Terence’s  Heauton  Timorumenos:  Homo  sum,  humani 
nihil  a  me  alienum  puto.  .  .  .  One  who  investigates  must  be  .  .  .  ready  to 
accept  .  .  .  anything  human  beings  think,  feel,  or  do  as  not  altogether  strange 
in  human  nature:  “  1  am  but  human  and  I  do  not  consider  anything  human  foreign 
to  me”;  it  is  at  least  worthy  of  human  consideration. 

He  was  convinced  that  there  was  no  way  of  stating  the  facts 
effectively  “except  by  stating  them  directly  and  concisely  in  terms 
of  actions  and  perhaps  also  in  terms  of  motives  and  prevailing 
desires  and  tendencies  taken  from  the  person's  point  of  view  rather 
than  from  that  of  the  critic  or  helper."  Such  general  terms  in  the 
record  submitted  to  him  as  “incorrigible,"  “immoral,"  “serious 
trouble,"  “not  very  well,"  “troublesome" — all  containing  a  judg¬ 
ment — were  unfortunate,  in  his  opinion,  because  they  did  not  give 
the  facts  which  would  have  enabled  anyone  else  to  judge  for  him¬ 
self. 

The  questionnaire  given  later  in  this  chapter  on  the  Child  Pos¬ 
sibly  Feeble-minded  (the  possibly  defective  adult  must  be  under¬ 
stood  to  be  included  in  this  title)  was  prepared  by  Mrs.  Hilbert  F. 
Day.  Mrs.  Day  also  made  the  first  draft  of  the  questionnaire 
here  given  on  the  Patient  Possibly  Insane.  This  has  been  revised 
and  added  to  by  Dr.  Thomas  W.  Salmon,  Medical  Director  of  the 
National  Committee  for  Mental  Hygiene,  to  whom  the  writer  is 
also  indebted  for  the  following  suggestions  to  be  observed  in  using  it : 

Great  stress  must  be  laid  upon  changes  in  mood,  mental  proc¬ 
esses,  activities,  and  social  reactions.  It  must  be  remembered 
too  that  the  apparent  mental  status  of  the  patient  varies,  in  its 
external  manifestations,  at  different  times  of  the  same  day — for 
example,  the  nocturnal  restlessness  and  cloudiness  of  toxic  and 
of  senile  cases.  Special  effort  should  be  made  to  ascertain  whether 
abnormal  manifestations  are  increasing  or  diminishing  in  number 
and  in  intensity,  as  this  often  has  a  practical  bearing  upon  the 
management  of  the  case.  It  might  be  suggested,  as  a  good  general 
guide,  that  weight  be  given  to  the  apparent  reasonableness  of  all 
activities.  There  could  be  unfavorable  answers  to  many  of  the 
following  questions  when  the  social  worker's  client  was  a  normal 
subject;  nevertheless,  the  reasonableness  of  this  or  that  activity  or 
this  or  that  reaction  under  the  circumstances  which  actually  existed 
is  the  significant  point. 


435 


SOCIAL  DIAGNOSIS 


QUESTIONNAIRE  REGARDING  A  PATIENT  POSSIBLY  INSANE 

It  should  be  repeated  here  that  nothing  in  the  following  questionnaire  must  be 
interpreted  to  mean  that  a  social  worker  is  ever  able  to  make  a  medical  diagnosis. 
This  is  not  a  schedule  to  be  filled  out  nor  a  set  of  queries  to  be  answered  by  a  social 
agency’s  client  or  clients.  For  an  explanation  of  the  purpose  of  these  question¬ 
naires  see  p.  373  sq. 

A  star  (*)  indicates  that  the  answer  to  the  question  may  be  found  in,  or  confirmed 
by,  public  records. 

I  History  of  Parents 

Social 

1.  Were  parents  of  patient  related?  In  what  degree? 

2.  Are  both  parents  living?  If  dead,  what  was  the  cause  of  death?*  Age  at 
death?* 

3.  What  has  been  their  general  standing  in  the  community?  Have  they  been  self- 
supporting,  self-respecting  people? 

4.  Has  either  parent  been  wholly  or  partially  dependent?  Had  institutional  care? 
Which  one?  What  institutional  or  other  care?  When? 

5.  What  have  been  their  occupations?  Have  they  been  successful  in  them?  If 
not,  to  what  cause  was  lack  of  success  due? 

Physical,  mental,  and  moral  characteristics  or  disabilities 

6.  Is  (or  was)  either  parent  deaf,  dumb,  blind,  or  deformed? 

7.  Have  they  been  considered  normal  mentally?  If  not,  in  what  way  abnormal? 

8.  Did  either  show  sexual  perversions?  Did  either  lead  a  dissolute  life? 

9.  Did  either  have  extraordinary  gifts?  One-sided  talents?  Vacillating  inter¬ 
ests?  Eccentricities?  Was  either  absorbed  in  “causes”  (for  example,  anti- 
Catholic,  litigious)?  Was  either  irritable? 

10.  Were  quarrels  frequent  in  the  family?  Did  parents  “take  sides”  regarding 
the  discipline  of  the  children?  Was  either  parent  too  lenient  or  too  severe  and 
to  what  extent? 

11.  Nervous  and  mental  disorders.  Was  either  excessively  nervous?  How  was 
nervousness  shown? 

12.  Did  either  parent  have  epilepsy? 

13.  Did  either  have  periodical  headaches?  Attacks  of  nervous  prostration?  Of 
what  nature? 

14.  Was  either  ever  insane?  When?  For  how  long?  At  what  age?  How  long 
before  or  after  patient  was  born?  To  what  causes  were  the  attacks  attributed? 
Were  they  cared  for  in  a  hospital? 

15.  Did  either  have  any  other  disorders?  St.  Vitus’s  dance?  Paralysis?  Apoplexy? 

16.  Did  either  have  constitutional  diseases?  Syphilis?  Tuberculosis? 

17.  Alcohol.  Was  either  addicted  to  the  use  of  alcohol  or  habit-forming  drugs? 
If  they  used  alcohol,  was  its  use  moderate,  excessive?  Occasional,  habitual? 
How  long  was  it  taken?  Years?  With  what  results?  Delirium  tremens? 

436 


the  insane 


Crime  and  suicide 

18.  Did  either  attempt  or  commit  suicide?  Under  what  circumstances? 

19.  Has  either  a  criminal  record?  What?* 

(The  same  points  of  history  should  be  considered,  where  the  situation  warrants 
it,  for  children  of  patient,  brothers  and  sisters  of  patient,  maternal  and  paternal 
grandparents,  uncles,  aunts,  and  cousins.) 

II  Patient’s  Early  History 

20.  Prenatal.  Within  the  year  before  this  patient  was  born,  was  either  parent 
(which  parent)  under  great  worry  or  strain?  Was  patient  legitimate?  Was 
either  parent  using  alcohol  or  drugs  excessively?  Engaged  in  particularly  ex¬ 
hausting  occupations?  III?  With  what  disease? 

21.  Gestation.  What  was  the  condition  of  the  mother  during  pregnancy,  with  re¬ 
gard  to  her  general  physical  condition?  Conditions  of  work?  Nourishment? 
Mental  condition? 

22.  Birth.  Was  patient  born  at  full  term?  If  not,  at  what  month?  Was  patient 
born  after  prolonged  labor?  With  instrumental  delivery?  Was  more  than  one 
child  born  at  this  time?  What  was  patient’s  weight  at  birth? 

Physical  history  of  infancy  and  early  childhood 

23.  Did  patient  have  convulsions?  How  old  was  patient  when  these  began? 
How  many  years  did  they  continue?  How  frequently  did  they  occur?  How 
long  was  each  seizure?  What  was  their  character,  in  detail?  (For  example,  was 
there  loss  of  consciousness,  local  or  general,  and  if  so,  how  brought  on?) 

24.  Did  patient  have  rickets? 

25.  What  other  diseases  did  patient  have?  When  and  with  what  results? 

26.  When  did  patient  learn  to  walk?  To  talk?  To  control  urine  day  and  night? 

27.  At  what  age  did  patient  reach  puberty?  By  what  symptoms  was  it  accom¬ 
panied?  Were  there  any  abnormal  changes  noticed  in  the  disposition,  character, 
or  instincts  at  this  time?  What,  in  detail? 

Schooling 

28.  When  did  patient  first  go  to  school?  Until  what  age  did  he  remain  in  school? 

29.  Did  patient  like  school?  Why  did  he  leave?  Grade  on  leaving? 

30.  What  special  difficulties  did  patient  have  with  lessons?  Pupils?  Teachers? 
Was  he  a  truant? 

31.  What  special  abilities  did  patient  manifest? 

Ill  Injuries,  Diseases,  and  Habits  of  Later  Life 

32.  Injuries  and  diseases.  Has  patient  had  any  injuries,  especially  head  injuries? 
How  was  patient  affected?  By  loss  of  consciousness?  With  convulsions? 

33*  Has  patient  had  gonorrhea?  Syphilis?  When?  What  treatment  for  the 
latter  and  with  what  result? 

34.  What  other  diseases  has  patient  had?  What  were  the  after-effects? 

437 


SOCIAL  DIAGNOSIS 


35.  Alcohol.  Has  patient  taken  alcohol  in  any  form?  Beer?  Wine?  Whiskey? 
Tonic?  Medicine?  How  long  has  he  been  taking  alcohol?  Has  its  use  been 
moderate,  excessive,  occasional,  habitual?  Has  he  ever  had  delirium  tremens? 

36.  What  is  the  effect  on  his  disposition?  Does  the  alcohol  make  him  pleasant  or 
disagreeable? 

37.  Other  habits.  Has  the  patient  taken  drugs — cocaine,  morphine,  opium,  or  any 
others — for  long  periods  of  time? 

38.  Occupations.  What  is  patient’s  present  occupation?  How  long  has  he  been 
engaged  in  it? 

39.  Does  he  like  it?  Is  he  doing  well  in  it?  What  difficulty  has  patient  had  with 
employes  or  employers? 

40.  What  previous  occupations  has  patient  had?  Highest  earnings?  Average 
during  last  five  years?  How  long  did  he  retain  each  position,  how  successful  was 
he  in  each,  and  why  did  he  leave  each? 

41.  Has  patient  worked  by  fits  or  with  regularity? 

42.  Sex  life.  What  were  earliest  sex  experiences?  With  same  or  opposite  sex? 
Did  patient  make  advances  or  vice,  versa?  Any  sexual  attacks  in  childhood  by 
older  relatives  (father,  uncles,  cousins)? 

43.  To  what  extent  has  patient  masturbated?  Before  puberty?  Afterwards? 
Has  he  sought  advice  on  this  subject? 

44.  What  suggestions  have  there  been  of  perverted  tendencies  (homosexuality,  ex¬ 
hibitionism,  “peeping,”  etc.)? 

IV  Marriage  and  Children 

45.  Is  or  has  the  patient  been  married?  When  was  he  married?  Is  the  wife  (hus¬ 
band)  still  living?  How  many  times  has  he  been  married?  What  judgment 
has  been  shown  in  marriage?  Has  the  married  life  been  happy?  If  not,  why 
not? 

46.  Has  the  patient  (or  wife)  had  any  gynecological  or  menstrual  difficulties?  When 
did  catamenia  begin?  Has  it  been  regular?  When  did  catamenia  end? 

47.  Has  the  patient  (or  wife)  had  abortions  or  miscarriages?  Still-births?  (Give 
the  details.)  How  often?  When?  How  were  they  brought  about? 

48.  Does  husband  (or  wife)  complain  of  patient’s  making  perverse  sexual  demands? 
What  ones? 

49.  How  many  children  has  patient  had?  What  is  the  sex  and  age  of  each?  From 
what  nervous  and  mental  diseases,  if  any,  have  they  suffered? 

V  Character,  Temperament,  Disposition,  and  Social  Instincts 

50.  Was  patient  thought  peculiar  in  childhood?  In  maturity?  In  what  way? 

51.  Does  patient  indulge  in  uncontrolled  fits  of  temper?  Has  patient  ever  done  so? 

52.  Is  patient  excitable?  Active?  Happy?  Does  patient  belong  to  the  “shut- 
in”  type,  being  unduly  quiet,  sad,  and  moody?  Given  to  day-dreaming? 

438 


THE  INSANE 


53.  Is  patient  free  and  confiding  or  reticent  and  seclusive? 

54.  Is  patient  self-confident P  Diffident?  Any  difference  in  this  respect  when  with 
opposite  sex? 

55.  Is  patient  introspective?  Does  patient  indulge  in  self-reproach?  Brood  over 
disappointments  and  incapacity? 

56.  As  a  child,  did  patient  show  any  markedly  lazy  traits?  Refuse  to  do  errands? 
Want  to  sleep  a  great  deal?  Stay  in  bed  for  long  periods?  Was  patient  easily 
frightened  and  subject  to  bad  dreams? 

57.  Is  religion  a  vital  part  of  patient’s  life?  Is  patient  over-religious?  Has 
patient  shown  special  interest  in  revivalism?  Clairvoyancy?  Spiritualism? 
Hypnotism? 

58.  Did  patient  play  normally  with  other  children  as  a  child,  getting  on  well  with 
them  and  entering  fully  into  their  games  and  good  times?  Was  he  inclined  to 
assume  an  air  of  superiority? 

59.  What  is  patient’s  attitude  toward  people?  Friendly  and  responsive  or  the  re¬ 
verse? 

60.  Does  patient  enjoy  companionship  or  prefer  being  alone  in  his  work?  In  his 
recreation?  At  home? 

61.  Is  patient  prone  to  passionate  attachments? 

62.  Is  patient  attached  to  home,  friends,  and  family,  or  indifferent  to  the  natural 
bonds  of  affection?  Attitude  toward  father?  Mother?  Marked  preference? 
Any  change  at  puberty? 

63.  Previous  attacks .  Has  the  patient  had  similar  attacks  before?  What  were  the 
symptoms?  How  long  did  the  condition  last?  Did  he  go  to  a  hospital  for  ner¬ 
vous  and  mental  diseases?  When?  Where?  For  how  long?  Why  discharged? 

64.  If  he  has  not  had  any  similar  attacks,  has  he  ever  had  periods  of  depression  or 
of  exaltation?  How  long  have  these  lasted?  What  was  done  during  these 
attacks? 

VI  History  and  Description  of  the  Present  Illness 

Cause  and  onset 

65.  Did  the  present  illness  seem  to  come  on  as  the  result  of  an  accident  or  disease? 
What,  in  detail? 

66.  Did  the  patient  have  a  physical  or  mental  shock?  What,  in  detail? 

67.  Has  he  been  under  extraordinary  strain  for  some  time? 

68.  Is  the  present  attack  thought  to  be  due  to  excess  of  any  sort?  Nature  of  excess? 

69.  Did  the  attack  come  on  gradually  or  suddenly?  Its  history  in  detail? 

Characteristics  of  attacks 

70.  General  physical  and  mental  changes.  Has  there  been  a  change  of  character  in 
the  patient  mentally?  Morally?  Socially?  Has  he  been  agreeable  or  disagree¬ 
able  to  his  wife  (husband)  and  children?  To  friends  and  neighbors?  Have 
they  considered  his  conduct  peculiar  or  remarkable?  In  what  respects? 

439 


SOCIAL  DIAGNOSIS 


71.  Has  he  appeared  to  be  dazed,  or  quiet,  or  restless?  Has  he  been  excited?  Has 
he  temporary  attacks  of  these  conditions?  Day  or  night? 

72.  Has  he  been  tidy  in  eating  and  in  his  other  habits,  or  has  there  been  a  distinct 
change  in  his  personal  habits  of  cleanliness  and  order? 

73.  Has  he  slept  well?  How  many  hours  has  he  slept  each  night?  Has  he  slept 
regularly? 

74.  Has  he  eaten  well,  or  little?  Has  he  had  a  perverse  or  abnormal  appetite? 
Has  he  taken  his  meals  regularly?  Does  he  give  any  explanation  for  his  poor 
appetite  or  his  refusal  to  eat? 

75.  What  was  the  patient’s  weight  before  the  illness  began?  Has  there  been  any 
change  in  his  weight?  What  other  changes  in  the  physical  condition  of  the  pa¬ 
tient  have  been  noted  since  the  beginning  of  the  illness?  Any  change  in  sex  life? 
Perversions  (see  questions  42  to  44)?  Has  he  been  tremulous  in  hands  or  in 
speech?  Slurring  in  speech?  Has  he  become  bald  or  has  his  hair  whitened? 

76.  Movements.  Are  there  abnormal  movements  of  the  body?  Of  the  head? 
Of  the  face?  Are  there  rhythmic  quiverings  of  the  mouth?  Are  there  wrinklings 
of  the  forehead?  Are  there  stereotyped  movements?  Are  his  movements  stiff 
and  constrained? 

77.  Emotional  condition,  especially  changes.  Has  the  patient  been  depressed,  or 
unduly  joyful,  or  apathetic? 

78.  Has  he  been  passionate,  or  inclined  to  anger,  or  threatening?  Has  he  become 
specially  sensitive  and  suspicious? 

79.  Hallucinations  and  delusions.  Has  he  heard  imaginary  voices?  What  have 
they  said?  Have  they  been  abusive?  Accusatory?  Has  he  had  visions? 
Dreams  so  realistic  that  they  seemed  reality?  Are  they  pleasant  or  unpleasant? 

80.  Did  he  go  through  the  house  looking  under  the  beds  and  the  furniture  and  in 
the  cupboards?  Did  he  listen  in  corners  or  at  the  walls?  Did  he  look  at  definite 
points  for  some  time? 

81.  Has  he  had  ideas  of  persecution  or  of  grandeur?  Does  he  think  he  is  being 
unduly  influenced,  watched,  or  poisoned?  Do  things  seem  unreal  to  him?  Does 
he  see  indirect  references  to  himself  in  newspapers,  casual  allusions,  literature, 
the  Bible?  Are  there  “undercurrents”  against  him?  Has  he  any  special  terms? 
What — murder,  poisoning,  insanity,  abduction?  Has  he  ideas  of  sin,  unworthi¬ 
ness,  impending  punishment? 

82.  Suicide  and  homicide.  Has  he  made  attempts  at  suicide?  At  homicide? 
What  were  the  exciting  causes?  Were  the  attempts  serious? 

83.  Intellectual  and  memory  defects.  -(Note  especially  beginning  and  duration  of 
changes  in  these.)  Has  he  shown  any  intellectual  defect?  Has  he  been  able  to 
carry  on  his  business  in  the  proper  manner?  Has  he  made  peculiar  or  ill  advised 
purchases?  Other  errors  in  judgment?  Has  he  lost  his  way  in  familiar  places? 
Does  he  remember  his  telephone  number?  Children’s  birthdays  and  birthplaces? 
Is  there  a  marked  difference  between  memory  for  recent  and  for  remote  events? 

440 


THE  FEEBLE-MINDED 


84.  Has  he  shown  any  other  defect  in  memory?  Has  he  remembered  his  business 
engagements?  Resorted  to  memoranda  and  devices  for  reminding? 

85.  Does  he  recognize  his  friends  or  relatives?  Does  he  mistake  persons? 

86.  Has  he  kept  track  of  the  days  of  the  week  and  of  the  month? 

87.  Has  he  known  where  he  has  been? 

88.  Moral  and  legal  laxness.  Has  the  patient  offended  against  the  law?  Against 
morality?  How  did  he  so  offend  and  with  what  result?  Has  he  made  threats? 
Written  to  prominent  persons?  Has  he  become  immodest  in  dress  and  attitude? 
Garrulous  as  to  family  and  personal  affairs? 

89.  Insight.  Has  he  understood  that  he  has  been  mentally  different  from  what  he 
is  normally?  Does  he  appreciate  the  nature  of  his  disorder? 

Description  of  patient 

90.  Does  the  patient  look  sad?  Apprehensive?  Furtive?  Gay?  Hostile?  Sus¬ 
picious?  Visionary?  Expressionless?  Intent?  Arrogant?  Sleepy? 

91.  How  does  he  carry  his  hands?  Is  his  hair  tidy  or  unkempt?  Nails?  Teeth? 
How  about  bathing?  Is  his  clothing  well  kept?  Does  he  show  that  he  has  been 
untidy  in  eating  and  in  drinking?  Any  attempts  at  unusual  dress  or  decoration? 
Is  he  fully  dressed,  half  dressed,  or  naked? 

92.  Does  the  patient  walk  straight  and  to  some  purpose?  Does  he  walk  irregu¬ 
larly  or  go  from  one  thing  to  another?  Does  he  go  slowly  or  quickly? 

93.  Does  he  voluntarily  complain  of  ill-being,  or  ill  treatment,  or  speak  of  his  de¬ 
lusions,  or  his  feelings? 

94.  Is  he  coherent?  Has  he  flight  of  ideas? 

95.  What  spontaneous  account  does  he  give  of  the  whole  situation? 


QUESTIONNAIRE  REGARDING  A  CHILD  POSSIBLY  FEEBLE-MINDED1 

Many  of  the  following  questions  apply  also  to  an  adult  in  years  who  is  not  an 
adult  in  mind.  It  should  be  repeated  that  nothing  in  the  following  questionnaire 
must  be  interpreted  to  mean  that  a  social  worker  is  ever  able  to  make  a  medical 
diagnosis.  This  is  not  a  schedule  to  be  filled  out  nor  a  set  of  queries  to  be  answered 
by  a  social  agency’s  client  or  clients.  For  an  explanation  of  the  purpose  of  these 
questionnaires  see  p.  373  sq. 

A  star  (*)  indicates  that  the  answer  to  the  question  may  be  found  in,  or  confirmed 
by,  public  records. 

Corrective  Defects,  Physical  and  Environmental  2 

1.  Is  child  well  nourished?  If  not,  to  what  cause  is  under-nourishment  due?  To 
poor  appetite?  Abnormal  appetite?  Insufficient  food?  Condition  of  the  teeth? 

2.  Has  he  been  pulled  down  by  rheumatism  or  any  of  the  childhood  infectious  dis¬ 
eases? 

1  Prepared  for  this  volume  by  Mrs.  Hilbert  F.  Day. 

2  Before  anyone  can  decide  that  the  child  is  feeble-minded,  due  consideration 
must  be  given  to  defects  needing  corrrection. 

441 


SOCIAL  DIAGNOSIS 


3.  Has  he  grown  rapidly?  At  the  appearance  of  permanent  teeth?  At  puberty? 

4.  Has  he  had  a  general  physical  examination?  When?  By  whom  and  with  what 
results?  Have  nose  and  throat  been  examined?  With  what  result?  Were 
tonsils  enlarged?  Were  adenoids  found?  Were  they  removed?  By  whom? 
When?  Has  vision  been  tested?  By  whom?  With  what  result?  Does  child 
wear  glasses?  When  was  last  examination?  Has  hearing  been  examined?  By 
whom?  When?  With  what  result?  What  is  the  condition  of  the  teeth? 

5.  Is  there  a  history  of  lack  of  proper  sleep? 

6.  Have  there  been  too  many  or  too  few  outside  interests?  Has  child  had  any 
emotional  distress  due  to  death  or  illness  of  loved  ones?  Has  his  home  been  un¬ 
happy?  Neglected?  How?  From  what  causes? 

7.  Is  there  any  marked  lack  of  sympathy  between  the  school  teacher  and  child? 
Does  the  position  of  his  desk  admit  of  good  light  and  opportunity  for  observa¬ 
tion? 


I  Etiology 

Heredity 

8.  What  was  the  age  of  each  parent  when  this  child  was  born?  Were  the  parents 
related  before  marriage?  In  what  degree?  Were  the  grandparents  on  either 
side  related  before  marriage?  Which  ones?  In  what  degree? 

9.  Are  both  parents  living?  If  either  is  dead,  what  was  the  cause  of  death?  At 
what  age  did  it  occur?*  Place  of  death?*  Date?*  If  the  grandparents  are 
deceased,  of  what  disease  and  at  what  age  did  each  die?* 

10.  Are  there  deceased  brothers  and  sisters?  If  so,  what  was  the  order  of  their 
birth,  their  sex,  age,  and  the  cause,  place,  and  date  of  their  death?*  Were  their 
mental  and  physical  powers  normal? 

n.  What  have  been  the  father’s  occupations?  The  mother’s?  At  what  age  did 
each  begin  work? 

12.  Did  father  or  mother  or  any  of  their  relatives  show  signs  of  or  tendency  towards 
the  following: 


Feeble-mindedness 
Imbecility 
Idiocy 
Deafness 
Blindness 
Being  dwarfed 
Being  crippled 
Being  deformed 


Tuberculosis 

Insanity 

Epilepsy 

Syphilis 

Convulsive  disorders 
Scrofula 

Great  nervousness 
Paralysis 
Neuralgia  4. 

Hysteria 
Sick  headache 
St.  Vitus’s  dance 


Intemperance 
Use  of  drugs 
Criminality 
Sexual  immorality 
Truancy 
Vagrancy 


In  which,  if  in  any,  member  of  child’s  immediate  family  have  any  of  these  signs 
or  tendencies  appeared? 


442 


THE  FEEBLE-MINDED 


13.  What  members  of  the  immediate  family  and  what  relatives,  if  any,  on  either 
side,  have  been  wholly  or  partially  dependent?  What  institutional  or  other 
care  have  they  received?  When? 

14.  Has  child’s  mother  had  any  still-births?  How  many  and  when?  Any  mis¬ 
carriages?  How  many  and  when?  Due  to  what  causes?  At  what  month  of 
pregnancy  did  they  occur?  What  is  the  order  of  child’s  birth— is  he  first-born, 
second-born? 

15.  Within  the  year  before  this  child  was  conceived,  was  either  parent  (which 
parent)  seriously  ill?  Under  great  worry  or  strain?  Under  mental  excitement? 
Using  alcohol  excessively?  Using  drugs,  such  as  opium,  etc.? 

Gestation 

16.  Was  there  anything  peculiar  to  be  noted  at  time  of  conception?  Were  there 
any  abnormal  conditions  of  the  mother  during  pregnancy?  Any  attempts  at 
abortion?  Did  mother  work  during  pregnancy?  How  steadily?  To  what 
period?  At  what  occupations?  Did  mother  have  sufficient  nourishment? 
Did  she  retain  it? 

17.  While  child  was  being  carried,  was  there  on  the  part  of  the  mother  any  disease 
that  had  begun  before  this  time?  Any  disease  begun  during  this  time?  What 
disease?  Was  there  any  abuse  of  alcohol  or  drugs?  Any  worry  or  anxiety? 
Any  fright  or  shock?  Any  peculiar  symptoms?  Anything  special  to  make  an 
impression  on  her  mind? 

18.  Was  this  child  born  at  full  term?  If  not,  at  what  month?  Was  more  than  one 
child  born  at  this  time? 

At  time  of  birth 

19.  How  long  was  the  labor?  Was  it  hard?  Were  anesthetics  used?  How  long? 
Were  instruments  used?  What  was  the  child’s  weight?  Did  child  suffer  from 
difficult  animation,  breathing,  or  crying?  Cyanosis,  injury,  deformity,  paraly¬ 
sis,  inability  to  suckle? 

II  Physical  History 

Pathological 

20.  Was  child  nursed  by  his  mother?  How  long?  How  was  he  fed  when  weaned? 

21.  Was  he  poorly  developed  in  any  way?  How  did  he  show  it?  Was  he  a  strong 
or  sickly  baby?  If  sickly,  how  did  he  show  it? 

22.  Has  he  ever  had  any  severe  shock,  fall,  or  fright?  Any  injury  to  the  head? 
When?  What  were  the  circumstances  and  apparent  results? 

23.  Has  child  ever  had  convulsions,  fits,  or  spells?  At  what  age  did  they  begin? 
To  what  cause  did  they  appear  to  be  due?  What  was  their  character?  How 
often  did  they  occur?  When  was  the  last  one?  What  treatment  had  been 
given  and  with  what  results? 

24.  Has  child  ever  had  epilepsy?  Rickets?  Paralysis?  Character  and  history 
of  attacks? 


443 


SOCIAL  DIAGNOSIS 


25.  Has  he  ever  had  measles,  whooping  cough,  scarlet  fever,  diphtheria,  cerebro¬ 
spinal  meningitis,  varioloid,  or  small-pox?  At  what  age  and  how  severely? 

26.  Has  child  ever  had  sore  eyes,  or  any  skin  or  scalp  disease?  Character  and 
history  of  trouble? 

27.  Has  he  ever  had  any  disease  of  lungs  or  bowels?  What? 

28.  Has  he  ever  been  pronounced  insane?  By  whom?  When?  Character  and 
history  of  attacks  that  led  to  this  diagnosis? 

29.  Has  he  ever  had  St.  Vitus’s  dance?  When? 

30.  What  other  diseases,  if  any,  has  he  had?  When? 

Development 

31.  When  did  child  teeth?  Recognize  persons?  Sit  alone?  Use  spoon?  Walk? 
Talk?  How  did  he  advance  in  weight  and  height?  How  did  he  compare  in 
these  respects  with  other  children  in  family?  Is  he  of  average  height  and  weight 
for  his  age? 

32.  At  what  age  did  child  reach  puberty? 

33.  When  were  first  signs  of  abnormal  development  noticed?  Nature? 

Peculiarities 

34.  How  is  child’s  circulation?  Are  his  hands  and  feet  often  cold?  Has  he  been 
known  to  blush? 

35.  How  does  he  sleep?  Well?  Restless?  Noisy?  Dream?  Any  night  terrors? 

36.  Is  he  sensitive  or  callous  to  cold?  Heat?  Pain?  Thunder  storms? 

37.  Is  appetite  quick  or  abnormal  in  any  way?  What  is  the  state  of  his  taste? 
Is  he  particular  about  what  he  eats?  Does  he  swallow  things  without  regard  to 
taste?  Is  he  gluttonous?  Will  he  eat  garbage? 

Appearance 

38.  What  is  the  general  balance  of  child’s  body?  Are  shoulders  equal?  Is  back 
bent?  Is  there  asymmetry  of  posture?  Are  there  any  abnormalities  in  the 
size  and  shape  of  the  head?  Does  head  loll  to  one  side  or  droop  forward? 

39.  Are  there  any  variations  from  the  normal  in  the  size,  shape,  and  relative  posi¬ 
tion  of  the  features?  Is  there  any  marked  coarseness  of  features?  Do  the  eyes 
roll?  Shift?  Are  they  wanting  in  changefulness?  Is  child  cross-eyed?  Are 
ears  large,  outstanding,  or  dissimilar?  Is  the  lower  jaw  protruding?  Is  mouth 
usually  open?  Are  there  any  abnormalities  in  the  form,  structure,  and  situation 
of  the  teeth? 

40.  What  is  the  expression  of  the  face?  Vacant?  Gaze  fixed?  Has  the  child  the 
normal  comeliness  of  youth?  Does  the  skin  show  extreme  pallor?  Any  other 
peculiarities? 

41.  Are  there  any  peculiarities  of  speech?  What,  in  detail? 

42.  Does  the  child  show  any  signs  of  nervousness?  Automatic  motions  of  the 
features,  hands,  fingers,  or  limbs?  Chronic  frowning?  Repeated  grinning? 

444 


___ — . 


THE  FEEBLE-MINDED 


III  Character 

Temperament  and  disposition 

43.  Is  child  dull,  listless,  restless,  or  excitable?  Is  he  active  and  vigorous?  Does 
he  run  about  and  notice  things,  or  is  he  indolent? 

44.  Is  he  affectionate?  Reclusive?  Vindictive?  Passionate?  Conceited? 
Boastful?  Ungenerous?  Ungrateful? 

45.  Is  he  often  wilful,  disobedient,  and  liable  to  attacks  of  stubbornness  and  bad 
temper?  Has  he  shown  himself  responsive  to  discipline  or  is  he  ready  to  risk 
punishment  for  slight  objects?  Is  he  easily  managed?  Docile?  Incorrigible? 

46.  Is  child  quarrelsome?  Does  he  organize  rebellion?  Is  he  fond  of  stirring  up 
trouble  and  tale  bearing?  Cunning  in  attaining  his  own  ends?  Easily  influenced? 

47.  Does  he  learn  by  experience?  Is  he  heedless  of  danger? 

48.  Has  he  sympathy  with  distress  or  suffering?  Is  he  dangerous  to  himself  or 
others  during  temper?  Does  he  show  embarrassment  or  shame  when  detected 
in  wrong-doing?  Does  he  show  remorse  after  wrong-doing? 

M  orality 

49.  Does  child  know  the  difference  between  right  and  wrong?  Is  he  truthful? 
Does  he  tell  senseless  lies?  Is  he  trustworthy?  Wantonly  dishonest?  Does  he 
indulge  in  purposeless  and  needless  offenses?  Will  he  pilfer? 

50.  Is  child  sexually  precocious?  Does  he  show  any  sexual  perversion  in  practice? 
By  telling  vulgar  stories? 

51.  Does  he  drink  or  use  drugs  or  tobacco?  To  what  extent? 

52.  Has  he  a  court  record?* 

Social  relationships 

53.  What  is  child’s  attitude  toward  parents?  Brothers?  Sisters?  Strangers? 
Playthings?  Is  he  violent  toward  playmates  or  an  “easy  mark”?  Is  he  cruel  or 
kind  to  animals?  To  children? 

54.  What  sort  of  associates  does  he  select?  Are  they  below  him  socially?  In¬ 
tellectually?  Are  they  younger,  weaker  physically?  Is  he  fond  of  other  chil¬ 
dren?  Does  he  help  in  the  care  of  other  children? 

55-  Does  he  show  any  excitement  when  in  the  presence  of  the  opposite  sex?  At 
what  age  was  this  first  noticed? 

56.  How  does  he  bear  himself  in  public  places? 

Habits 

57.  What  are  child’s  habits  in  regard  to  personal  appearance?  Is  he  tidy?  Un¬ 
clean?  Careless?  Vain  in  dress?  Is  there  a  marked  difference  in  these  respects 
between  this  child  and  the  other  members  of  the  family?  Does  he  wet  or  soil 
clothing?  Bedding? 

58.  Is  he  given  to  self-abuse?  Has  he  ever  been? 

59.  Will  he  hide,  break,  or  destroy  things?  Clothing?  Furniture? 

445 


SOCIAL  DIAGNOSIS 


60.  Is  he  dangerous  with  fire? 

61.  Does  child  show  tendency  to  run  away  from  home?  From  school?  From 
work? 

62.  Has  he  any  unfortunate  habits  not  mentioned? 

Peculiarities 

63.  Does  child  laugh  or  cry  without  cause?  Quarrel  without  cause?  Talk  over 
intimately  about  himself?  Is  he  prejudiced  against  anyone  without  reason? 
Is  he  liable  to  uncontrollable  anger  for  trifling  cause? 

64.  Is  the  character  subject  to  abrupt  change  or  alternation?  Are  there  any  strik¬ 
ing  contradictions  in  character?  Is  child  tender  and  cruel?  Ingenuous  and 
crafty?  Phlegmatic  and  nervous?  Unfeeling  and  affectionate?  Frank  and 
secretive?  Artless  and  shy?  Deceitful  and  truthful? 

65.  Are  there  periods  of  uncontrollable  fear,  of  being  impelled  to  violence,  intoxica¬ 
tion,  or  to  immoral  or  criminal  action?  Have  there  been  any  periods  of  religious 
enthusiasm? 

IV  Capacity 

Intellectual 

66.  What  schools  has  child  attended?  How  old  was  he  when  he  left?  Why  did 
he  leave?  What  grade  did  he  reach  in  school?  What  is  his  history  as  to  pro¬ 
motion?  Has  he  been  held  in  one  grade  more  than  two  years  with  regular  atten¬ 
dance?  Has  he  ever  attended  a  special  class,  been  regarded  as  subnormal,  or 
been  studied  by  a  child-study  department? 

67.  In  school  is  child  attentive?  Easily  fatigued  by  mental  effort?  Can  he  hold 
his  interest  in  one  subject  continuously?  Does  he  lose  interest  quickly?  Does 
he  need  careful  and  close  supervision?  In  what  does  he  do  his  best  work?  His 
poorest? 

68.  Does  he  recognize  form?  Which  by  name?  Does  he  recognize  color?  Which 
by  name?  Can  he  count?  How  many?  Can  he  read?  How  much?  Can  he 
add?  Subtract?  Multiply?  Divide?  Is  he  fond  of  music?  What  is  his 
musical  capacity?  Does  he  delight  in  acting?  What  is  his  power  of  memory? 
Does  he  commit  to  memory  easily?  How  long  does  it  take  him  to  learn,  say,  four 
lines?  Does  he  soon  forget  what  he  has  learned?  Can  he  speak  a  piece? 

Recreational 

69.  How  does  child  amuse  himself?  Can  he  entertain  himself  while  alone?  Does 
he  show  any  initiative  or  spontaneity  in  games?  Does  he  show  any  imagination 
in  play? 

70.  In  what  stories  is  he  interested?  Vulgar?  Blood  and  thunder?  Gruesome? 
How  long  will  child  play  at  any  one  thing?  What,  for  example? 

Co-ordination  of  faculties 

71.  What  is  child’s  power  of  imitation? 

446 


the  feeble-minded 


72.  How  does  he  respond  to  a  command?  Is  he  slow?  Will  he  respond  incorrectly 
though  trying  to  obey?  Can  he  do  an  errand? 

73-  Is  he  right-handed?  Left-handed?  Ambidextrous?  Is  the  left  hand  more 
dextrous  and  stronger  than  the  right?  Is  his  grip  weak? 

74-  Can  child  use  knife  and  fork?  Does  he  masticate  properly? 

75-  Can  he  throw  a  ball?  Catch  a  ball?  Can  he  button  clothes?  Tie  a  knot? 
Lace  shoes?  Put  on  overshoes? 

76.  Can  child  write,  draw,  sew?  In  drawing,  writing,  sewing,  and  manual  training, 
is  co-ordination  of  hands  and  fingers  labored?  How  does  he  write,  from  right  to 
left?  In  writing,  is  there  a  conspicuous  number  of  i’s  undotted  or  t’s  uncrossed, 
a  lack  of  capitals?  Can  he  take  a  simple  dictation? 

77.  Can  he  handle  tools?  What  can  he  make? 

Industrial 

78.  Can  child  do  any  kind  of  work?  What  work  has  he  done?  When  did  he  begin 
work?  Is  he  thorough  in  it?  Can  he  work  without  supervision?  Does  he  keep 
his  positions?  Can  he  support  himself? 

V  Home 

79-  Is  home  in  a  crowded  or  a  suburban  district?  Any  grounds?  What  is  the 
character  of  the  neighborhood,  physical  and  moral?  Single  house  or  flat? 
Number  and  size  of  rooms?  Number  used  for  sleeping?  Ventilation?  Light 
or  dark?  Orderly  or  disorderly?  Clean  or  dirty?  Character  of  furnishings? 
Condition  and  location  of  toilets? 

80.  What  is  the  size  of  family?  Are  parents  living  together,  or  are  they  divorced 
or  separated?  Of  what  members  is  immediate  family  group  composed?  Sex, 
ages,  and  occupations?  Are  there  any  other  members  of  the  household?  What 
is  their  relation  to  the  family? 

Attitude  of  household  toward  child 

81.  Do  family  consider  child  abnormal?  To  what  cause  do  they  assign  his  condi¬ 
tion?  Inheritance?  Accident?  Acute  sickness?  Any  other  reason? 

82.  Do  the  parents  have  patience  with  child?  Have  they  a  strong  attachment  for 
him? 

83.  What  is  his  relation  with  other  children  in  the  household?  Do  they  abuse  or 
tease  him?  Is  he  repulsive,  and  does  his  appearance  have  a  bad  effect  on  the 
other  children?  Is  he  a  source  of  terror,  or  is  he  the  butt  of  the  household? 

84.  Who  is  responsible  for  the  child  s  care?  How  continuous  is  the  supervision? 
How  often  is  he  left  alone  or  with  an  irresponsible  member  of  the  household? 
What  degree  of  watchfulness  and  intelligent  care  can  be  expected  for  him  at 
home? 

85.  What  is  the  nature  of  the  home  training?  Is  he  neglected?  Unduly  repressed, 
abused,  or  overindulged?  Do  parents  or  guardian  control  child?  How?  By 
fear  of  corporal  punishment?  By  affection  and  reason? 

447 


SOCIAL  DIAGNOSIS 


Personal  hygiene 

86.  Is  his  bedroom  large  or  small?  How  many  windows  has  it?  Are  the  windows 
kept  open?  Does  he  sleep  alone?  With  whom?  In  a  single  or  double  bed? 
What  time  does  he  go  to  bed  and  get  up?  Does  he  drink  tea,  coffee,  milk,  or 
cocoa?  How  much?  Usual  food,  breakfast,  dinner,  supper?  Bathing,  how 
often?  What  kind?  Does  he  use  a  toothbrush?  Are  his  bowels  regular? 

VI  Plan 

87.  Would  parents  be  willing  to  have  child  placed  in  an  institution?  What  is  the 
opinion  of  teachers,  relatives,  and  physicians  as  to  the  wisdom  of  such  a  step? 


448 


CHAPTER  XXVIII 

SUPERVISION  AND  REVIEW 

THE  foregoing  analyses  of  the  diagnostic  side  of  a  few  social 
disabilities  are  only  a  beginning.  Should  the  plan  followed 
prove  helpful  in  actual  practice,  other  disabilities  can  be  ana¬ 
lyzed  in  the  same  way. 

The  questionnaire  of  this  closing  chapter  turns  from  disabilities, 
which  are  not  always  the  most  important  consideration  in  social 
work,  to  the  other  diagnostic  topics  likely  to  be  of  service  to  a  case 
work  supervisor.  When  inquiry  into  a  client’s  situation  has 
reached  the  stage  of  evidence  gathered  but  not  yet  compared  or 
interpreted,  and  the  record  comes  to  a  supervisor,  or  when,  in 
the  absence  of  supervision,  the  case  worker  must  review  the  evi¬ 
dence  without  assistance,  what  are  the  things  to  look  for?  This 
final  list  of  questions  is  an  attempt  to  answer  the  query.  Needless 
to  say,  it  does  not  indicate  a  routine  to  be  followed;  some  ques¬ 
tions  will  apply  to  the  given  case  but  many  will  not. 

The  writer  has  had  helpful  suggestions  for  this  list  of  queries 
from  former  students,  especially  from  members  of  the  1916  Charity 
Organization  Institute.  Page  numbers  after  questions  indicate 
where  fuller  discussion  of  the  subject  may  be  found  in  this  book. 

SUPERVISION  AND  REVIEW  QUESTIONNAIRE 

I  Relations  with  Client 

1.  Does  the  record  of  the  first  interview  indicate  that  the  client  has  had  a  fair  and 
patient  hearing,  and  that  a  sympathetic  understanding,  or  at  least  a  good  basis 
for  further  intercourse,  was  established  at  this  early  stage?  (p.  1 14)1 

2.  Are  there  indications  that  advice  has  been  given  prematurely,  or  that  promises 
have?  (p.  129)  Or  has  the  client  been  put  off  with  such  artificial  reasons  for 
delay  or  inaction  as  “my  committee,”  “we  never  pay  rent,”  “this  is  contrary 
to  the  rules  of  the  institution,”  etc.?  Have  there  been  too  many  ultimatums? 
Have  “no-thoroughfare”  situations  developed  between  case  worker  and  client 
due  to  these,  due  to  failure  to  sift  contradictions,  etc.?  Are  there  signs  that  the 
worker’s  lack  of  grasp  of  the  situation  has  developed  the  scolding  habit? 

1  All  page  references  are  to  other  parts  of  this  volume. 

449 


29 


SOCIAL  DIAGNOSIS 


3.  Were  good  clues  to  outside  sources  of  insight  and  co-operation  procured  in  the 
first  interview?  (p.  120)  What  clues,  indicated  as  possible  by  the  story,  seem  to 
have  been  neglected?  Do  these  belong  to  a  group  which  this  case  worker  often 
finds  it  difficult  to  get,  or  usually  overlooks? 

4.  Were  the  possible  signs  of  physical  or  mental  disease  or  breakdown  noted  early, 
and  were  medical  examination  and  care  procured  immediately  thereafter?  (p. 
21 1)  If  the  assumption  that  the  client  was  lazy,  indifferent,  or  incorrigible  was 
made,  was  it  possibly  due  to  neglect  of  these  precautions? 

5.  Has  the  worker  who  has  conducted  the  first  interview  and  seen  the  client’s  fam¬ 
ily  also  seen  the  important  outside  sources,  or  were  these  parts  of  the  inquiry 
entrusted  to  someone  else?  (p.  176)  Does  the  information  procured  from  out¬ 
side  sources  suggest  that  the  inquirer  had  a  sense  of  the  relation  of  the  part  to 
the  whole? 

6.  Were  any  confessions,  especially  those  that  were  damaging  to  the  client  who  made 
them,  accepted  as  necessarily  true?  (p.  71)  Has  the  client  been  protected  from 
misrepresentation  of  any  kind? 

II  Relations  with  Client’s  Family 

7.  Does  the  record  give  its  reader  a  sense  of  the  main  current  of  the  lives  of  the 
people  recorded,  or  does  it  detail  unrelated  episodes  and  incidents  only?  (p.  138) 

8.  Have  the  relations  of  the  members  of  the  family  to  one  another  been  noted? 
Have  any  crises  been  noted  that  tested  the  family  power  of  cohesion?  (p.  139) 

9.  Does  the  record  reveal  whether  the  family  has  or  has  not  shown  good  judgment, 
on  the  whole,  in  its  economic  choices?  Have  expenditures  been  the  expression 
of  an  innate  craving,  have  they  been  due  to  imitation,  or  are  they  indicative  of 
little  judgment? 

10.  Are  characteristic  disabilities  belonging  to  the  racial  or  economic  group  all 
charged  against  the  individual  family? 

1 1 .  Have  the  children  of  the  family,  especially  the  growing  children,  been  individual¬ 
ized?  (p.  153)  Is  there  any  clear  picture  of  both  their  home  and  school  life? 
If  the  problem  is  a  family  one,  have  the  older  children,  those  who  are  grown  and 
at  work,  been  consulted?  (p.  155) 

12.  Has  the  man  of  the  family  been  seen?  Were  he  and  his  wife  seen  separately? 
(P-  M3) 

III  Use  of  Outside  Sources 

13.  Was  the  confidential  exchange  consulted  promptly?  (p.303)  Was  the  identi¬ 
fying  information  there  procured  promptly  followed  by  consultations  with  the 
agencies  named?  (p.  308)  Were  any  inquiries  that  had  already  been  made  by 
these  agencies  unnecessarily  duplicated?  (p.  31 1)  Were  the  different  agencies 
each  consulted  about  the  kind  of  fact  that  each  was  best  able  to  give?  (p.  297) 
Has  any  transfer  of  the  case  to  another  agency  for  treatment  been  preceded  by 
sufficient  inquiry  to  justify  the  reference?  (p.  313) 

450 


SUPERVISION  AND  REVIEW 


14.  If  not  all  the  clues  to  outside  sources  were  followed  up,  does  an  intelligent 
choice  seem  to  have  been  made?  For  example,  were  some  relatives  on  both  sides 
of  the  house  seen,  some  former  employers,  etc.?  (p.  175)  Was  the  order  in 
which  the  sources  were  consulted  wisely  chosen?  (p.  170)  Were  any  of  the 
sources  consulted  found  through  supplementary  clues — clues  revealed  casually, 
that  is?  (p.  174) 

15.  Have  statements  been  sought,  as  far  as  possible,  at  first  hand  and  not  through 
intermediaries— from  doctors,  for  example,  rather  than  from  patients,  where 
medical  facts  were  in  question,  etc.?  (p.  172)  Or  has  hearsay  evidence  been 
accepted  without  challenge?  (p.  58)  In  evaluating  the  testimony  of  witnesses, 
has  their  personal  bias  been  allowed  for?  (p.  73) 

16.  Has  the  worker  expressed  opinions,  in  the  letters  attached  to  the  record  or  else¬ 
where,  on  matters  about  which  he  is  not  informed?  Have  the  outside  sources 
been  consulted  about  possible  plans  of  action,  or  have  they  merely  been  per¬ 
suaded  to  agree  to  plans  proposed  by  the  case  worker?  (p.  293) 

17.  In  first  contacts  with  relatives,  have  questions  of  the  material  assistance  pro¬ 
curable  from  them  obscured  more  important  matters?  (p.  195) 

18.  Are  the  medical  diagnoses  from  which  social  inferences  have  been  drawn  up-to- 
date?  (p.  216)  Has  discrimination  been  shown  in  seeking  medical  advice,  and 
has  the  needless  multiplication  of  medical  advisers  been  avoided?  (p.  213) 

19.  Are  the  school  reports  quoted  merely  formal  ones,  or  have  the  individualized 
observations  of  teachers  been  sought?  (p.  223) 

20.  Have  the  work  records  been  entered  perfunctorily,  or  do  they  cover  the  points 
that  would  be  of  value  in  procuring  new  work,  reinstatement,  or  advancement? 
(See  list  of  suggestions  on  page  239.)  Has  underpaid  or  unwholesome  work  that 
tended  to  disintegrate  the  family  life  (such  as  the  twelve  hour  shift,  supplemen¬ 
tary  earning  by  the  homemaker  away  from  home,  sweatshop  work,  or  premature 
withdrawal  of  children  from  school)  been  noted? 

21.  Is  any  inexactness  in  the  data  at  hand  due  to  failure  to  consult  original  docu¬ 
ments  of  birth,  marriage,  baptism,  death,  property,  immigration,  or  court  pro¬ 
ceedings?  (p.  255)  Or  to  failure  to  consult  out-of-town  directories?  (p.  265) 
Or  newspaper  files?  (p.  269) 

22.  Were  interviews  with  present  neighbors  limited  quite  strictly  to  procuring 
needed  court  evidence?  (p.  274)  Have  the  characteristics  of  the  neighborhood 
been  kept  in  mind,  and  have  experienced  neighborhood  social  workers  been  con¬ 
sulted  about  them?  (p.  299) 

IV  Conduct  of  the  Inquiry  as  a  Whole 

23.  Have  all  the  assets  for  reconstruction  revealed  by  the  client’s  history  been  care¬ 
fully  and  sympathetically  noted?  Have  they  been  summed  up  in  black  and 
white?  Or  are  there  signs,  on  the  other  hand,  of  a  tendency  to  overemphasize 
the  discouraging  things?  (pp.  157,  357,  and  360) 

24.  What  indications  are  there  of  the  case  worker’s  habits  as  a  questioner?  Have 
leading  questions  been  asked  with  full  knowledge  of  their  danger,  and  with  good 

451 


SOCIAL  DIAGNOSIS 


reason  for  taking  the  risk?  (p.  71)  Have  any  marked  personal  prejudices  of 
the  case  worker’s  been  allowed  to  warp  the  account?  (pp.  94  and  97) 

25.  Is  there  evidence  of  a  tendency  to  substitute  such  formulae  as  "maladjustment,” 
"underfeeding,”  “chronic  laziness,”  "hopelessly  shiftless,”  "drink  the  sole  cause,” 
"large  family,”  "insufficient  wages,”  for  the  specific  fact  or  facts?  Are  there 
indications  that  the  worker  is  hampered  by  some  professional  habit  useful 
under  other  conditions  but  not  here?  (p.  96)  Are  there  signs  of  automatism, 
of  following  a  routine  unthinkingly? 

26.  Has  the  worker  been  careful  to  clear  up  unfavorable  items  of  evidence  instead  of 
leaving  them  neither  proved  nor  disproved? 

27.  Has  the  worker  been  hurried  into  hasty  and  ill  considered  action  by  a  tendency 
to  cross  bridges  before  they  are  reached,  to  regard  situations  as  "emergent” 
that  are  not  really  so?  Has  some  picturesque  minor  incident  of  the  story  de¬ 
moralized  the  inquiry?  (p.  139) 


28.  Is  there  a  tendency  to  "make  out  a  case”  at  all  hazards  by  overemphasizing 
one  side?  Has  the  worker  "held  a  brief”  for  or  against  or  has  he  dealt  even? 
Are  first  theories  promptly  abandoned  when  the  facts  tend  to  disprove  them? 
(p.  98) 


29.  What  hypotheses  and  inferences  of  the  worker  and  of  others  have  been  accepted 
without  the  necessary  testing?  (p.  87)  Have  any  popular  explanations  of 
things  been  accepted  without  challenge? 

30.  With  regard  to  the  record  itself,  does  it  develop  an  individual  and  colorful 
picture,  or  are  the  main  issues  obscured  by  repetition  and  by  unverified  im¬ 
pressions?  Does  it  show  skill  in  what  is  omitted?  Is  the  present  situation,  for 
example,  described  in  such  detail  as  to  throw  the  more  permanent  aspects  of  the 
story  out  of  perspective?  Are  the  words  used  as  specific  as  they  might  be? 
(p.  349)  Are  general  terms  avoided?  Are  acts  described  instead  of  qualities? 
(p.  435)  Are  the  statements  of  the  record  merely  added  or  are  they  weighed? 
Are  there  brief  entries  that  help  the  supervisor  to  understand  the  relation  of  an 
unknown  witness  to  the  matter  about  which  he  is  quoted  and  to  measure,  in 
some  degree,  his  disinterestedness  and  his  personal  characteristics?  (p.  278) 

31.  Are  there  signs  of  wasting  time,  of  doing  relatively  unimportant  things  under 
the  impression  that  there  is  no  time  for  the  important  ones?  Does  the  investi¬ 
gation  center  round  and  round  some  one  point  in  the  story,  or  does  it  lose  itself 
in  aimless  visits,  many  times  repeated,  to  the  client  or  his  family?  Are  there, 
on  the  other  hand,  signs  of  "economy  of  means,”  of  achieving  results,  that  is, 
with  the  fewest  possible  motions  and  the  smallest  possible  friction? 

32.  Has  the  inquiry,  as  it  has  developed,  supplied  a  reasonable  explanation  for  the 
present  situation?  Does  the  investigation,  that  is,  lay  bare  the  personalities  of 
the  chief  actors  plus  the  factors  external  to  themselves  that  have  brought  them 
to  their  present  pass?  Does  it  look  back  to  their  highest  achievement  in  the  past, 
and  give  any  sense  of  their  possible  resources  in  the  joint  task  of  reinstatement 
or  development  which  is  still  ahead?  How  far  does  the  inquiry  suggest  not  only 
the  diagnosis  of  the  difficulty,  but  plans  for  its  constructive  treatment?  (p.  360) 


452 


SUPERVISION  AND  REVIEW 


33-  ^  needed  evidence  has  not  been  procurable,  and  only  partial  or  temporary 
diagnosis  can  be  made,  what  modifications  in  treatment  could  be  devised  in 
order  that  a  part  of  its  necessary  services  might  become  also  a  means  of  pushing 
the  investigation  forward?  (pp.  86  and  236) 

V  Wider  Aspects  of  the  Inquiry 

34.  Is  the  record  one  in  which  this  case  worker  has  tried  to  make  an  especially 
thorough  and  skilful  inquiry?  If  not,  are  there  any  such  records?  (p.  362) 

35.  Does  it  contain  an  instance  of  effort  to  push  further  into  an  unsolved  problem 
by  presenting  it,  in  this  concrete  form,  to  specialists  in  the  national  social  reform 
associations  or  elsewhere  who  might  be  able  to  suggest  a  solution?  (Examples: 
the  possible  relations  between  occupation  and  disease  in  a  given  case;  the  prob¬ 
lem  of  the  energetic  boy  who  wishes  to  sell  papers  out  of  school  hours;  the 
chances  of  recovery  for  tuberculous  patients  returned  to  their  own  country — when, 
for  instance,  a  case  committee  suggests  sending  back  such  a  one  to  Messina,  etc.) 

36.  If  there  is  no  adequate  provision  for  the  feeble-minded,  or  no  legal  redress  when 
housing  conditions  threaten  health  (to  give  only  two  instances),  what  attitude 
does  the  record  reveal  toward  these  evils?  Is  the  situation  accepted,  or  is  a  dis¬ 
position  manifest  to  push  hard  in  some  helpful  direction?  Is  the  evidence  bear¬ 
ing  upon  the  matter  accurately  enough  stated  in  the  record  to  make  it  part  of 
the  data  needed  for  community  action? 

37.  Are  there  any  hopeful  signs  of  breaking  through  routine,  of  getting  a  result  by 
new  or  unusual  methods?  What  new  outside  sources,  for  example,  have  been 
brought  to  light?  (See  list  of  outside  sources  in  Appendix  II,  Table  A,  p.  467.) 
Have  any  such  new  methods  been  noted  and  placed  at  the  service  of  other  case 
workers? 

38.  If  anyone  has  made  an  inquiry,  supplied  information,  or  aided  at  this  stage  of 
the  case  in  any  way  if  a  teacher  has  shown  interest,  for  example — will  that 
interest  be  remembered  and  will  it  be  strengthened?  Has  any  note  been  made, 
looking  to  that  end,  to  report  later  upon  the  further  developments  of  the  case, 
especially  upon  any  really  significant  ones? 


APPENDICES 


APPENDIX  I 

FIRST  INTERVIEWS 

HE  three  analyses  of  First  Interviews  which  follow  have  been  selected 
from  a  larger  number  submitted  in  response  to  the  questions  given  on  p. 
120.  The  first  is  with  a  patient  in  a  medical-social  department,  the  second 
with  a  deserted  wife  in  the  office  of  an  associated  charities,  and  the  third  was  held 
in  the  home  of  a  young  wife,  a  colored  woman,  who  had  just  lost  a  child.  Care  has 
been  taken  to  change  these  interviews  in  minor  details,  which  leave  unchanged  their 
value  as  interviews  but  perhaps  make  the  identification  of  the  persons  interviewed 
less  possible. 

1.  ANALYSIS  OF  INITIAL  INTERVIEWS  WITH  A  PSYCHONEUROTIC 

PATIENT 

Patient  is  brought  into  Social  Service  De¬ 
partment  by  doctor  from  Male  Medical  Clinic, 
who  tells  worker  that  the  case  is  clearly  one  of 
apprehension.  Boy,  sixteen  years  old,  is  phys¬ 
ically  sound.  He  lost  his  mother  when  very 
young,  is  unhappy,  and  has  given  up  his 
work,  because  he  became  afraid  he  was  sick. 

What  he  needs  is  a  friend,  somebody  who 
will  care  and  who  will  get  him  started. 

During  this  conversation  patient  is  sitting 
on  the  bench.  He  is  a  handsome  boy,  with  a 
very  attractive  smile,  looks  a  little  embar¬ 
rassed,  but  gets  up  with  a  friendly  smile 
when  doctor  introduces  worker  to  him.  Is 
greeted  cordially,  worker  shakes  hands  and 
asks  him  to  wait  a  few  moments  while  she 
finishes  a  conversation  with  another  patient. 

Boy  has  evidently  a  real  admiration  for  the 
doctor. 


In  a  short  time  patient  is  invited  to  sit  by 
worker’s  desk.  Worker  explains  to  him  that 
the  doctor  has  not  time  enough  to  go  into 

457 


It  is  very  helpful  to  have  doctor 
introduce  patient  to  worker.  He 
thus  shows  patient  that  he  trusts 
worker  and  that  he  believes  in  her 
power  to  help  patient. 

Worker  can  inspire  confidence 
in  patient  by  her  manner,  which 
should  always  be  cheerful  and  at 
ease. 


SOCIAL  DIAGNOSIS 


all  the  details  of  his  case,  but  wishes  a  study 
of  it  made,  and  that  she  and  he  will  study  it 
together.  Patient  assents. 

It  is  then  explained  to  patient  that  he  must 
be  prepared  to  answer  a  great  many  questions 
and  to  tell  everything  he  can  think  of  about 
himself  and  his  family.  Is  told  that  if 
worker  had  known  him  all  his  life  she  would 
know  how  many  brothers  and  sisters  he  had, 
and  where  he  had  been  to  school,  but  that 
now  he  has  come  to  her  out  of  clear  sky.  He 
is  like  a  figure  standing  in  front  of  a  white 
screen.  He  has  no  background.  As  no¬ 
body  in  real  life  stands  in  front  of  a  white 
screen,  patient  must  paint  in  the  details. 
He  understands  and  says  he  will  be  glad  to 
help  and  will  answer  every  question. 

As  it  is  late  in  the  morning  patient  is  in¬ 
vited  to  come  in  again  next  day  and  is  told 
that  the  necessary  study  may  take  several 
interviews. 

When  patient  comes  in  again  record  is 
begun  by  asking  him  where  he  has  been  pre¬ 
viously  treated.  He  had  never  had  a  doctor 
until  the  year  before  when  his  brother’s  doc¬ 
tor  saw  him  a  few  times. 


This  puts  the  emphasis  upon  the 
objective  point  of  view  and  makes 
patient  a  little  less  self-conscious. 

Again  manner  plays  an  impor¬ 
tant  part.  This  is  said  as  if  worker 
and  patient  were  about  to  begin 
an  interesting  game.  This  re¬ 
lieves  patient’s  embarrassment  if 
he  feels  any. 


Patient  is  evidently  amused  and 
interested  and  says  he  will  be  glad 
to  come  again. 


Worker  helps  patient  to  con¬ 
centrate  his  attention  upon  this 
“study”  by  the  businesslike  way 
of  writing  down  his  answers  to 
questions,  or  the  narrative  he  gives 
unassisted.  This  places  social 
record  on  same  plane  as  medical 
record  in  his  mind  (a  part  of  his 
treatment),  since  it  is  taken  in 
same  manner,  and  shows  him  that 
doctor  considers  it  all  important. 
This  rule  is  broken  only  when  in  a 
more  confidential  part  of  the  story 
patient  needs  the  help  of  an  en¬ 
couraging  look,  or  undivided  at¬ 
tention  from  worker. 

After  initial  record  is  made, 
taking  notes  is  usually  unneces¬ 
sary,  though  worker  never  hesi¬ 
tates  to  take  them  if  anything 
important  is  told.  It  keeps  in 
patient’s  mind  the  fact  that  doc¬ 
tor  is  in  touch  with  case. 


458 


FIRST  INTERVIEWS 


It  is  then  explained  to  patient  that  the 
study  of  his  case  necessitates  his  telling  all 
he  can  remember  about  his  family.  He  is 
asked  about  his  grandparents.  The  only 
one  he  knows  anything  about  (the  others 
having  died  in  Austria)  is  his  father’s  father, 
who  is  alive  and  in  this  country.  Patient 
has  apparently  no  affection  for  him,  and  says 
he  is  “cross  and  quick-tempered”  and  hard 
to  get  along  with;  does  not  stay  long  with 
any  of  his  children.  Is  pretty  well  physi¬ 
cally. 

His  father  is  a  teacher.  Does  not  seem 
to  know  how  to  describe  him  until  worker 
asks  several  questions.  Then  says,  “  He  is  a 
good-natured  man,  sometimes  gets  his  tem¬ 
per  up,”  but  is  good  to  his  children.  Came 
to  the  U.  S.  eighteen  years  ago;  has  lived  in 

D - ever  since;  was  married  when  he  was 

seventeen.  Is  honest;  much  thought  of 
among  his  fellow-countrymen,  but  earns  a 
very  small  salary.  In  Austria  his  position 
was  very  different.  Is  unable  to  help  his 
sons  much. 

Mother  died  when  patient  was  only  three. 
He  can  remember  nothing  about  her.  This 
fact  seems  to  have  taken  a  certain  hold  upon 
his  imagination. 

Patient  has  three  brothers  and  a  sister  and 
there  is  evidently  much  affection  among 
them.  They  are  all  older  than  he  and  while 
his  sister  was  at  home  she  looked  out  for 
him.  He  tells  of  their  education,  occupa¬ 
tions,  and  marriage  with  very  little  question¬ 
ing. 

About  five  years  ago  his  father  married 
again  and  patient  has  not  been  happy  with 
his  stepmother.  Just  at  present  he  is  living 
with  a  sister  of  his  mother. 

As  patient  complains  of  pain  in  his  side, 
he  is  told  what  a  habit  pain  is — a  vicious 
circle,  “attention  creates  sensation,  sensa- 

459 


While  at  first  puzzled  to  know 
what  is  wanted,  patient  is  very 
responsive.  Fatigue  in  attention  is 
avoided  by  the  many  interruptions 
which  come  to  worker.  Though 
these  interrupt  narrative  they 
have  their  uses. 

Patient  shows  little  interest  in 
ancestry. 


Great  care  is  taken  to  ask  ques¬ 
tions  which  describe  opposing 
traits  so  that  patient  may  not 
have  answers  to  questions  sug¬ 
gested  to  him. 


Patient  unconsciously  finds  in 
this  loss  excuse  for  many  of  his 
weaknesses. 


After  patient  understood  what 
sort  of  description  was  necessary 
in  his  father’s  case  he  described  the 
others  quite  easily. 


n 


\ 


SOCIAL  DIAGNOSIS 


tion  causes  fear,  fear  increases  attention,” 
which  must  be  broken  through  at  the  point 
of  fear,  because  patient  is  afraid  the  pain 
means  something  serious.  As  the  doctor  has 
pronounced  him  physically  sound,  patient  is 
urged  to  rest  his  faith  in  this  statement.  He 
is  reminded  of  his  relations  to  other  people 
and  the  possible  effect  of  his  discouraged 
attitude  upon  them.  He  is  going  out  of 
town  to  visit  one  of  his  brothers  for  a  few 
days,  but  will  come  again  on  his  return.  He 
is  asked  to  write  down  anything  he  can  re¬ 
member  of  his  life. 


His  responsibility  toward  others 
is  suggested  to  him  from  the  be¬ 
ginning. 


This  is  intended  to  keep  his 
interest  in  the  study  alive.  This 
leisurely  way  of  taking  the  record 
is  designed  to  suggest  to  patient 
that  he  must  not  expect  to  over¬ 
come  his  bad  habits  at  once. 
Thoroughness  is  much  more  im¬ 
portant  than  speed. 


Immediate  effect  is  seen  in  a  postal  re¬ 
ceived  from  patient  the  next  day  in  which 
he  writes,  ‘‘I  am  feeling  fine.” 


Five  days  later  patient  comes  again.  Had 
felt  perfectly  well  till  “yesterday  when  the 
old  pain  had  appeared  again,”  and  he  is 
feeling  a  bit  discouraged.  He  brings  a 
written  statement  of  some  facts  in  his  life — 
his  proneness  to  stay  by  himself,  his  industry 
at  school,  his  lack  of  all  intellectual  interests 
outside  of  his  school  work.  Family  are  very 
poor  and  patient  does  not  get  on  well  with 
his  stepmother,  though  he  stayed  at  home 
after  all  the  others  went  away,  because  he 
wanted  to  get  an  education. 

Record  is  taken  up  again  and  family  his¬ 
tory  is  continued.  Patient  tells  of  his 
father’s  and  mother’s  relatives;  then  of 
what  he  had  done  since  school;  his  habits — 
how  he  spends  his  time,  what  he  eats,  etc. 
His  not  having  earned  anything  for  four 
months  is  not  a  real  source  of  worry  to  him, 
as  his  family  are  all  good  to  him. 


A  patient  is  very  apt  to  respond 
quickly,  but  when  he  feels  his  old 
sensations  come  again,  discourage¬ 
ment  follows. 


Document  is  read  and  patient 
is  encouraged  to  write  more,  and 
more  fully  and  freely.  This  is  to 
increase  his  personal  interest  in 
study  and  gives  him  opportunity 
to  express  his  own  views  without 
chance  of  suggestion  from  worker. 


These  facts  make  rough 
of  patient’s  background. 


sketch 


460 


FIRST  INTERVIEWS 


He  is  evidently  of  a  retiring  disposition, 
though  not  unfriendly. 


Question  of  finances  not  taken 
up,  unless  pressing,  until  later. 


Record  is  here  interrupted  by  a  long  talk 
on  habit  and  patient’s  future  plans.  His 
former  ambitions  seem  to  be  suspended  by 
his  fears  about  his  health.  Worker  suggests 
that  she  will  visit  patient’s  oldest  brother. 


On  the  following  day  patient  comes  to 
continue  record.  This  part  of  record  is  the 
most  intimate  as  it  relates  to  his  earliest 
recollections,  the  people  and  things  which 
have  most  affected  him.  He  tells  of  his 
school  life,  of  the  principles  which  govern  his 
conduct,  of  his  troubles  and  of  his  chief 
difficulty,  which  has  been  deciding  things. 


The  next  step  is  to  visit  the  patient’s 
brother.  He  is  devoted  to  patient  and  is  a 
kind  and  sensible  man.  Future  plans  for 
patient  are  discussed  and  brother’s  co-opera¬ 
tion  fully  won. 


The  following  day  patient  comes  in  with  a 
longer  written  statement  than  the  first.  The 
initial  interview  is  completed  with  his  ac¬ 
count  of  the  cause  and  duration  of  his  illness. 
He  is  much  interested  to  hear  about  worker’s 
visit  to  brother.  It  is  decided  he  is  to  go  to 
this  brother  very  soon.  He  is  encouraged 
to  read  ten  minutes  every  day  and  to  think 
about  his  reading.  He  is  asked  to  report 
about  it  to  worker.  He  is  also  advised  to 
learn  some  good  poetry.  He  is  promised  a 
list  of  books  to  read;  is  urged  to  decide  some 
little  thing  every  day  and  to  stick  to  his  de¬ 
cision. 


Patient’s  interest  is  still  further 
aroused  by  this  personal  interest. 
Brother  lives  30  miles  away. 


Worker  tries  in  words  and  man¬ 
ner  to  impress  patient  with  her 
interest.  This  part  is  the  test  of 
her  power  to  convince  patient  of 
her  real  sympathy.  She  also  learns 
almost  as  much  from  what  he  does 
not  say  as  from  what  he  tells.  His 
manner  is  illuminating. 


This  not  only  helps  worker  very 
much  in  her  knowledge  of  patient’s 
surroundings  and  family,  but  gives 
patient  a  common  interest  with 
worker. 


It  is  impressed  upon  patient 
that  this  is  only  the  opening  wedge 
in  his  recovery.  Care  is  taken  not 
to  urge  future  plans  upon  patient 
as  it  is  deemed  wiser  to  encourage 
more  healthful  habits  of  thought 
and  let  his  ambitions  come  to  life 
slowly.  He  is  so  young. 

It  is  best  to  avoid  permitting 
patient  to  depend  too  much  upon 
worker’s  will  power. 


461 


SOCIAL  DIAGNOSIS 


2.  AN  OFFICE  INTERVIEW  WITH  A  DESERTED  WIFE 


On  the  first  of  May,  a  woman  aged  twenty- 
two  and  two  children,  two  and  a  half  and 
one  year  old,  are  brought  to  the  office  by  an 
officer  who  gives  this  information: 

The  woman  was  deserted  by  her  husband 
three  weeks  before.  She  has  since  been  liv¬ 
ing  with  her  parents,  but  was  turned  out  two 
days  ago  because  she  made  slighting  remarks 
about  her  sister’s  fiance.  The  sister  and 
mother  whipped  her.  The  officer  had  hoped 
that  her  family  would  take  her  back,  but  her 
father  was  seen  this  morning  and  refused. 
Both  the  mother  and  this  daughter  have 
violent  tempers. 

The  interview  begins  with  questions  re¬ 
garding  the  name  and  age  of  husband  and 
wife.  When  was  she  married? 

“Three  years  ago  by  a  Lutheran  minister.” 

“Are  you  Scandinavian  then?” 

“No,  mostly  mixed,  I  guess.” 

“Tell  me  about  your  married  life,  have  you 
had  trouble  like  this  before?” 

She  launches  into  her  story,  saying  that 
they  were  getting  along  very  nicely  in  Mill- 
bank.  Her  husband  was  not  drinking  much 
and  was  supporting  her.  Then  he  sent  her 
here  on  a  visit  and  came  himself  and  now  he 
has  left. 

“When  were  you  in  Millbank?” 

“Since  last  August.” 

“What  was  his  work  there?” 

“Switching.  That  is  what  he  was  doing 
here.  He  showed  me  a  pass  just  before  he 
left  but  I  have  forgotten  where  it  was  to.” 

“Had  you  just  quarrelled  or  had  you  any 
trouble  that  would  make  him  go  away?” 


These  are  direct  questions,  the 
idea  being  to  find  whether  the  hus¬ 
band  ran  away  because  he  was  too 
young  for  his  responsibilities. 

This  gives  a  chance  for  a  ram¬ 
bling  story  which  follows. 


Maybe  by  returning  to  Mill- 
bank,  if  man  is  found,  life  could 
be  made  happier. 


Trying  to  find  the  cause. 


In  reply  to  this  she  tells  of  a  previous  time 
when  he  deserted  after  selling  some  things 
which  did  not  belong  to  him  while  working 
for  an  installment  house.  Her  people  did 
not  like  this  any  more  than  they  liked  his 
getting  her  in  trouble  before  her  marriage. 

462 


► 


FIRST  INTERVIEWS 

She  is  asked,  “Was  he  willing  to  marry  A  forced  marriage  might  ex- 
you  or  did  he  do  it  against  his  will?”  plain  his  dishonesty,  recklessness. 

She  says  he  was  not  unwilling,  though  not  and  desertion, 
anxious.  He  made  no  objection,  however, 
when  her  father  insisted.  But  ten  days 
after  their  marriage  he  was  arrested  for  try¬ 
ing  to  steal  a  bicycle  while  he  was  intoxi¬ 
cated.  Another  time  he  spent  two  months 
in  the  Parktown  workhouse  for  defrauding 
grocers. 

She  is  asked.  Did  she  know  he  drank  and 
was  dishonest  before  marriage. 

She  says  not,  but  that  his  responsibilities 
seemed  to  him  too  heavy  as  a  man  of  family. 

He  was  good  only  while  in  Millbank. 

“Did  he  like  the  children?” 

“While  in  Millbank  he  seemed  to  like  them 
all  right.” 


The  woman  is  then  asked  about  her  own  With  a  view  to  solving  the  ques- 
health  and  what  work  she  did  before  mar-  tion  of  how  she  is  to  live  till  he  is 

na8e-  found,  or  perhaps  permanently. 

Her  health  is  good.  She  was  a  mangle 
girl  in  a  laundry. 

Did  she  begin  work  early? 

When  she  was  sixteen  years  old.  Her 
father  did  not  wish  any  of  his  girls  to  work, 
but  they  all  did  because  they  wanted  more 
clothes  than  he  could  furnish  them. 


A  day  nursery  is  suggested. 

She  does  not  like  this  idea  as  she  says  the 
baby  keeps  her  up  a  good  deal  at  night. 
She  would  rather  put  the  children  in  a  home 
and  work  in  a  laundry. 

She  is  shown  that  thus  she  would  have  to 
leave  the  children  to  the  care  of  others  and 
is  urged  to  consider  the  nursery  plan. 

Meanwhile,  has  she  anywhere  to  go? 

She  mentions  two  relatives  of  hers,  one  of 
whom  is  telephoned  to.  This  relative  will 
not  have  her  and  does  not  wish  to  become 
involved. 

The  client  then  remembers  her  husband’s 
half-sister,  who  is  telephoned  to.  The  sister 
says  she  will  give  temporary  shelter  but 

463 


The  possession  of  a  telephone 
suggests  that  her  people  are  better 
able  to  help  than  are  many. 

A  note  is  made  to  look  up  this 
sister-in-law  and  hold  a  private 
conversation  with  her  face  to  face. 


SOCIAL  DIAGNOSIS 


regrets  that  the  client  did  not  take  her  ad¬ 
vice  before  marriage.  The  nursery  plan  is 
explained  to  her  and  she  thinks  it  good. 

The  woman  is  then  told  that  an  effort  will  ^  not  thought  wise  to  insist 

be  made  to  find  her  husband  and  to  call  later  on  day  s  work  or  any  plan  until  she 

to  talk  over  plans.  She  is  sent  to  her  sister-  begins  to  recover  her  courage, 
in-law’s. 


3.  A  FIRST  INTERVIEW  IN  THE  HOME 


A  young  colored  couple  was  referred  on  account  of  the  death  of  one  of  their 
children,  for  whom  they  wished  burial  clothing  and  assistance  toward  the  funeral 
expenses,  because  the  man  was  unemployed.  The  secretary  had  been  warned 
that  Mrs.  Reynolds  (to  give  her  another  name)  was  in  a  very  hysterical  state,  and 
that  it  would  probably  be  impossible  to  get  any  information  at  all. 

On  approaching  the  old  wooden  shanty,  where  Mrs.  Reynolds  lived,  the  writer 
heard  a  series  of  moans  and  groans.  She  found  the  mother  sitting  on  a  tumbled 
bed,  rocking  her  body  to  and  fro.  Her  eyes  were  tearless,  but  the  moaning  con¬ 
tinued.  The  visitor  laid  her  hand  on  the  woman’s  shoulder  and  the  latter,  quiet 
for  an  instant,  looked  up  inquiringly. 

“How  do  you  do,  Mrs.  Reynolds?  I  am  so  glad  I  found  you  in,  because  Mrs. 
Miller  would  have  been  so  disappointed  if  I  had  not.” 

“Oh,  do  you  know  Mrs.  Miller?”  asked  the  woman,  immediately  brightening, 
“Ain’t  she  a  fine  woman?” 

“Indeed  she  is,”  answered  the  visitor,  and  allowed  the  colored  woman  to  run  on 
for  a  few  moments  eulogizing  Mrs.  Miller,  for  whom  she  worked  two  days  a  week, 
as  it  seemed  to  take  her  mind  off  of  her  loss  and  to  calm  her.  She  explained  that 
Mrs.  Miller  had  known  her  husband  and  herself  when  they  were  first  married,  and 
had  been  very  friendly  to  them  ever  since.  By  immediately  following  this  lead,  it 
was  possible  to  learn  where  they  were  married,  what  her  husband  did  for  a  living  at 
that  time,  and  the  kind  of  employment  he  now  wanted.  In  this  way  were  also 
jearned  some  of  the  places  at  which  he  had  worked  and  the  addresses  at  which  the 
family  had  lived  at  the  time. 

“  Did  you  have  two  children  when  you  were  down  on  North  Street?”  asked  the 
secretary,  knowing  that  a  direct  question  about  the  names  and  ages  of  the  children 
would  probably  start  a  fresh  outbreak  of  grief. 

“No,  I  just  had  Willie.  He  was  two  then,  and  after  we  moved  up  here  in  1910, 

Jessie  came  and  poor  Margaret  would  be  two  next  month  if  she - .”  Here  the 

visitor  interrupted  quickly,  “  I  imagine  the  children  are  very  bright  in  school, 
aren’t  they,  Mrs.  Reynolds?  Do  they  go  to  public  school  No.  2?” 

“Yes,”  answered  the  mother,  “and  they  bring  home  such  fine  grades.” 

“Of  course  you  send  them  to  Sunday  school,  probably  to  the  Colored  Mission 
around  the  corner,”  continued  the  visitor. 

“Yes,  we  all  go  there,”  answered  Mrs.  Reynolds.  “The  funeral  is  going  to  be 
from  there  tomorrow  afternoon.” 

“  Is  the  church  going  to  help  toward  the  expenses?” 

“No,  but  Dobson  is  very  reasonable.  He  is  only  going  to  charge  $38.” 

464 


FIRST  INTERVIEWS 


"Well,  perhaps  the  relatives  will  all  contribute  a  little." 

"  1  haven’t  any  relatives,”  was  the  conventional  reply. 

"Won’t  you  get  a  little  insurance  perhaps?”  was  the  next  suggestion. 

"No,  the  Metropolitan  lapsed  three  weeks  ago.” 

"  Do  you  get  two  carriages  for  the  amount  you  are  paying  the  undertaker,  or 
just  one?”  inquired  the  visitor  further. 

"Oh,  we  get  two.” 

"That’s  good,”  said  the  visitor,  "because  your  own  little  family  can  go  in  one 
carriage,  and  then  you  can  fill  the  other  with  just  your  nearest  relatives,  not  people 
who  come  out  of  curiosity,  but  your  own  kin.” 

"Yes,  we  have  asked  my  sister  and  her  husband  to  go  and  also  Amos’  brother 
John,  with  his  wife  and  child,”  continued  Mrs.  Reynolds. 

"You  are  fortunate  to  have  your  own  people  living  right  near  you.  All  of  us  are 
not  that  lucky.” 

“  I  reckon  we  are,  and  they  are  pretty  good  to  us.  Of  course  we  see  more  of  my 
sister,  Judy,  for  she  lives  just  two  doors  from  the  corner.  But  Amos’  brother  lives 
down  on  East  St.,  so  he  does  not  get  up  so  often.” 

In  another  two  minutes  the  secretary  was  able  to  get  not  only  the  names  and 
addresses  of  these  relatives,  but  a  general  idea  of  the  status  of  their  families. 

Finally  the  question  of  burial  clothes  for  the  child  had  to  be  approached  and, 
sobbing  hysterically,  Mrs.  Reynolds  showed  the  child’s  ragged  little  wardrobe,  so 
that  her  visitor  might  judge  what  was  needed.  The  office  card  was  left  in  the 
mother’s  hands,  and  she  promised  to  come  there  the  next  morning  at  nine  o’clock, 
when  the  secretary  was  to  accompany  her  to  the  department  store  where  they  could 
buy  the  necessary  articles.  After  a  few  last  words  of  warm  sympathy  and  encour¬ 
agement,  the  visit  was  over. 

The  chief  point  in  this  case  (continues  its  reporter)  is  the  importance  of  the  first 
contact.  It  shows  that,  when  one  finds  an  applicant  in  an  abnormal  state  of  mind, 
the  key  to  the  situation  is  to  introduce  upon  entrance  a  topic  that  will  be  of  im¬ 
mediate  and  real  personal  interest,  and  at  the  same  time  to  touch  lightly  upon  the 
subject  preying  upon  his  mind. 

The  real  problem  is  to  keep  the  client  from  gravitating  to  the  source  of  his 
trouble  until  one  is  ready  to  have  him  do  so;  this  is  achieved  by  keeping  up  a  rapid 
interchange  of  firm  but  kind  questions  and  answers,  allowing  no  time  for  lapses  of 
attention  on  the  part  of  the  person  interviewed.  One  would  find  it  difficult  to  get 
a  good  first  statement  in  a  case  like  the  foregoing,  if  the  order  were  reversed;  if 
the  client  were  encouraged  to  speak  of  his  trouble  first  in  the  interview,  that  is, 
before  the  background  had  been  secured. 

Then  another  important  thing  illustrated  is  the  necessity  of  having  a  legitimate 
introduction.  In  this  case  it  was  through  a  mutual  acquaintance,  Mrs.  Miller. 
If  the  visitor  had  come  in  some  mysterious,  undefined  way,  she  would  have  found  it 
difficult  to  gain  Mrs.  Reynolds’  confidence.  In  this  type  of  case,  moreover,  it  is 
especially  important  that  the  client  get  it  firmly  established  in  his  mind  that  the 
visitor’s  attitude  is  one  of  sympathy  and  of  determination  to  help  in  every  way 
possible.  With  this  impression  left  from  the  interview,  the  next  contact  will  be 
frank  and  friendly. 

30 


465 


APPENDIX  II 


STATISTICS  OF  OUTSIDE  SOURCES 

FORM  USED 


l.  AGENCY 


2.  CITY 


SOURCES  OF  INFORMATION  USED  AS  A  BASIS  OF  TREATMENT 

^  RECORD  No  4-  Form  of  service  asked  for . .  5*  Date  home  first  visited ~ . 19 

(Indicate  «ex  by  check) 

6.  SOCIAL  STATUS  y  Widowed . 

,  ,  c .  Deserted 

(Put  check  opposite  right  one)  ,  ,  ,  „  .  . 

d.  Divorced  or  legally  separated  . 

Female 

Male 

7.  N  umber  of  children. . . 

8.  Age  of  each  child: 

PERSONAL  VISITS  WERE  MADE  TO  OR  BY,  OR  LETTERS,  TELEGRAMS  OR  TELEPHONE  MESSAGES 
WERE  EXCHANGED  WITH  THE  FOLLOWING  SOURCES 

Note  i  -•  Count  >11  of  the  nine  lttad  of  eootnee,  lm.,  nil  clergymen,  el!  phjr»idar>«,  etc.,  and  enter  the  total  of  each  in  town  and  out  of  town  in  the  appropriate  column,  not  checking  ae  above. 
Nora  2:  If  ar.y  of  the  information  eecured  before  the  tret  important  decision  ae  to  treatment  of  this  case  was  made,  came  not  directly  but  through  a  responsible  agency,  write  name  of 
agency  after  the  original  source  printed  below. 


Total  of  each 


Total  of  each 


9.  CLi’rcb 

Connection* 

10.  Employer* 

11.  Friend* 

12.  Landlord* 

13.  Lawyer* 

14.  Medical 

Agencies 


IS-  Neighborhood 
References 


16.  Pawnbroker* 

17.  Private 

Social 

Agencies 


Clergymen . 

Fellow  Church  Members  . 

Sunday  School  Teachers  . 

Former . 

Present . .  •  • 

Former . 

Present . . 

Physicians  ........... 

Dentists . .  ■  • 

Hospitals  and  Sanatoria «* 

Dispensaries . 

purses . . 

Midwives . .  .  .  . 

Social  Service  Departmen 
Former  Neighbors  . 

Present  “ 

Former  Tradesmen 
Present  “ 

C.  O.  S.  or  Associated  Charities 
Foreign  Relief  Societies . 

Other 

Homes  for  Adults  ,  . 

“  Children  .  .  . 
Children’s  Aid,  etc.  .  .  . 

S.  P.  C.  C.  or  Humane-  Soc 

Day  Nurseries . . 

Settlements  .  ...  .  .  .  . 

(Specify  other  sources)  .  .  >  *  * 


18.  Public 
Officials 


Almshouse  . 

Charities  Departments  . 
Health  “ 

Police 

Court  “ 


1  n  Out  of 
town  town 


Public  Juvenile  Probation  .... 
Official*  Adult  “•  •  ■  •  . 

(CnnffmwA  Municipal  Lodging  House 
Prison  or  Reformatory  .  . 

U.  S.  Consuls . ,. 

Foreign  Consuls  ...... 

(Specify  other  sources)  .  .  f  .  . 


19.  Public 


Birth 


Record*  of  Baptism  „  . 

Death  .  .  . 


Contagious  Disease ..... 

Marriage  .  .  .' . 

Divorce  or  Legal  Separation 

Property . 

Guardianship . . 

Insurance . . 

(Specify  other  sources) . .  * 


In  Out  of 
town  town 


20.  Relative*  . . 

21.  School  Teachers . . 

Official*  Truant  Officers . 

Medical  Inspectors  ahd  Nurses  • 

School  Visitors . 

Fellow  Pupils . .  .  .  . 

22.  Social,  Trade  Trade  Unions . 

and  Benefit  Fellow  Workmen . 

Societies  Political  Clubs . .  .  . 

Benefit  Societies  .  1  r  .  .  1  -.  . 
Other  Clubs  .  ■ . 

23.  Unclassified  (Sptdfy  each  wm**) . 


466 


STATISTICS  OF  OUTSIDE  SOURCES 


TABLE  A. — SOURCES  OF  INFORMATION  CONSULTED  IN  THREE  CITIES, 
AS  SHOWN  BY  THE  RECORDS  EXAMINED 


Source 

Consultations11  in 

All  con¬ 
sultations51 

First 

city 

Second 

city 

Third 

city 

Social  agencies,  private  and  public 

C.  O.  S.  or  associated  charities 

480 

68 

97 

645 

Public  charities  departments 

212 

57 

6 

275 

Foreign  relief  societies 

46 

37 

9 

92 

Other  relief  societies 

167 

48 

4 

219 

Almshouses 

23 

6 

2 

3  1 

Private  homes  for  adults 

32 

12 

4 

48 

Private  homes  for  children 

1 16 

12 

15 

143 

Municipal  lodging  houses 

3 

,  . 

3 

6 

Children’s  aid  societies,  etc. 

1 1 1 

3 

4 

1 18 

S.  P.  C.  C.  or  humane  societies 

1 1 1 

1 1 

122 

Juvenile  probation 

61 

•  . 

1 1 

72 

Day  nurseries 

44 

1 

2 

47 

Settlements 

83 

13 

23 

1 19 

Organizations  to  provide  for  mothers 

with  infants 

12 

1 1 

,  , 

23 

St.  Vincent  de  Paul  Society 

17 

1 

18 

Adult  probation 

65 

1 1 

5 

81 

Legal  aid  societies 

7 

.  . 

6 

13 

Y.  W.  C.  A. 

4 

2 

3 

9 

Y.  M.  C.  A. 

6 

1 

1 

8 

Others  b 

94 

29 

3 1 

154 

Total 

1,694 

323 

226 

2,243 

Medical  agencies 

Physicians 

564 

65 

171 

800 

Dentists 

6 

.  # 

,  . 

6 

Hospitals  and  sanatoria 

357 

67 

34 

458 

Dispensaries 

124 

28 

24 

176 . 

Nurses 

103 

12 

16 

13  * 

Midwives 

#  # 

1 

1 

Social  service  departments 

122 

24 

1 

147 

Total 

1,276 

196 

247 

1,7*9 

a  Counting,  in  any  one  case,  only  the  first  consultation  with  each  source  used. 

b Under  the  headings  “Others”  and  “Miscellaneous”  are  grouped:  (i)  sources 
very  infrequently  consulted,  (2)  sources  somewhat  more  frequently  consulted  but 
only  by  a  single  agency  in  one  city.  On  the  other  hand,  a  few  sources  very  infre¬ 
quently  consulted  are  specified  (see,  for  example,  dentists,  midwives,  municipal 
lodging  houses,  U.  S.  consuls,  passports,  employment  offices)  because  they  are 
known  to  have  proved  useful  in  other  social  agency  records  not  included  in  this 
review  or  are  believed  to  offer  possibilities  of  usefulness. 


467 


SOCIAL  DIAGNOSIS 

TABLE  A. — SOURCES  OF  INFORMATION  CONSULTED  IN  THREE  CITIES, 

as  shown  by  the  records  examined. — ( Continued ) 


Consultations21  in 

Source 

First 

city 

Second 

city 

Third 

city 

All  con¬ 
sultations21 

Neighborhood  sources 

182 

Former  neighbors 

132 

3i 

19 

Present  neighbors 

182 

139 

210 

53  1 

Former  landlords,  agents,  janitors 

118 

120 

18 

256 

Present  landlords,  agents,  janitors 

106 

131 

78 

3*5 

Former  tradesmen 

22 

2 

6 

30 

Present  tradesmen 

3i 

9 

•5 

55 

Lodgers,  former  and  present 

1 

7 

9 

17 

Total 

592 

439 

355 

1,386 

Relatives 

769 

297 

12 1 

1,187 

Public  officials13 

Health  departments 

81 

22 

6 

109 

Police  departments 

358 

18 

16 

392 

Courts 

107 

3 1 

22 

160 

Prisons  or  reformatories 

36 

1 

50 

87 

U.  S.  consuls 

1  ' 

1 

.  . 

2 

Foreign  consuls 

5 

•  • 

6 

1 1 

Immigration  departments 

3 

10 

13 

Postmasters 

5 

2 

2 

9 

District  or  county  attorneys 

.  . 

4 

15 

19 

Others  c 

1 5 

1 1 

8 

34 

Total 

61 1 

90 

135 

836 

Employers  and  other  work  sources 

69 

Former  employers 

330 

7i 

470 

Present  employers 

147 

50 

35 

232 

Trade  unions 

1 1 

2 

13 

Fellow  workmen 

16 

.  . 

5 

21 

Employment  offices 

4 

3 

•  • 

7 

Total 

508 

124 

1 1 1 

743 

School  officials 

16 

485 

Teachers  and  principals 

280 

189 

Truant  officers 

63 

12 

2 

77 

Medical  inspectors  and  nurses 

75 

1 1 

1 

87 

School  visitors 

34 

4 

38 

Total 

452 

2 16 

19 

687 

a  Counting,  in  any  one  case,  only  the  first  consultation  with  each  source  used. 

b  With  the  exception  of  those  connected  with  almshouses,  public  charities  de¬ 
partments,  municipal  lodging  houses,  juvenile  and  adult  probation,  and  a  small 
number  of  miscellaneous  public  social  activities. 

c  Under  the  headings  “Others”  and  “Miscellaneous”  are  grouped:  (i)  sources 
very  infrequently  consulted,  (2)  sources  somewhat  more  frequently  consulted  but 
only  by  a  single  agency  in  one  city.  On  the  other  hand,  a  few  sources  very  infre¬ 
quently  consulted  are  specified  (see,  for  example,  dentists,  midwives,  municipal 
lodging  houses,  U.  S.  consuls,  passports,  employment  offices)  because  they  are 
known  to  have  proved  useful  in  other  social  agency  records  not  included  in  this 
review  or  are  believed  to  offer  possibilities  of  usefulness. 

468 


STATISTICS  OF  OUTSIDE  SOURCES 


TABLE  A. - SOURCES  OF  INFORMATION  CONSULTED  IN  THREE  CITIES 

as  shown  by  the  records  examined. — (Continued) 


Source 

Consultations21  in 

All  con¬ 
sultations21 

First 

city 

Second 

city 

Third 

city 

Friends 

302 

106 

183 

591 

Public  records  of 

Birth 

139 

>4 

153 

Baptism 

36 

6 

42 

Death 

28 

28 

Contagious  disease 

19 

>9 

Marriage 

M3 

,  . 

M3 

Divorce  or  legal  separation 

16 

16 

Property 

36 

1 

4 

4i 

Guardianship 

7 

#  # 

7 

Insurance 

15 

15 

Court 

2 1 

1 

28 

50 

Immigration 

4 

6 

10 

Passport 

3 

3 

Insanity  commitment  papers 

30 

30 

Othersb 

7 

1 

10 

18 

Total 

501 

32 

42 

575 

Church  sources 

Clergymen 

264 

42 

39 

345 

Church  visitors  or  missionaries 

20 

*3 

2 

35 

Fellow  church  members 

76 

2 

<•  23 

101 

Sunday  school  teachers 

2 1 

2 

1 

24 

Total 

3?^ 

59 

65 

505 

Lawyers 

7 

14 

97 

Benefit  societies  and  other  clubs 

Benefit  societies 

16 

4 

7 

27 

Other  clubs 

3 

2 

5 

Total 

19 

4 

9 

32 

Boarding  homes  for  children 

14 

13 

.  . 

27 

Fellow  pupils 

25 

1 

.  . 

26 

Detectives 

16 

1 

1 

18 

Foster  parents 

10 

•  . 

.  . 

10 

Pawnbrokers 

3 

.  . 

4 

7 

Miscellaneous15 

46 

48 

88 

182 

Grand  total 

7.295 

1,956 

1,620 

10,871 

a  Counting,  in  any  one  case,  only  the  first  consultation  with  each  source  used. 

b  Under  the  headings  “Others”  and  “Miscellaneous”  are  grouped:  (i)  sources 
very  infrequently  consulted,  (2)  sources  somewhat  more  frequently  consulted  but 
only  by  a  single  agency  in  one  city.  On  the  other  hand,  a  few  sources  very  infre¬ 
quently  consulted  are  specified  (see,  for  example,  dentists,  midwives,  municipal 
lodging  houses,  U.  S.  consuls,  passports,  employment  offices)  because  they  are 
known  to  have  proved  useful  in  other  social  agency  records  not  included  in  this 
review  or  are  believed  to  offer  possibilities  of  usefulness. 

469 


SOCIAL  DIAGNOSIS 


TABLE  B. — SOURCES  OF  INFORMATION  CONSULTED  IN  THE  FIRST 


Agencies  engaged  in  work  with  children 


Source 

Juvenile  court 

Reform  school  for  girls 

S.  P.  c.  c. 

State  department  for 

the  care  of  children 

City  department  for 

the  care  of  children 

Placing-out 

agencies 

Children’s  institution 

Day  nursery 

First  agency 

Second  agency 

Third  agency 

Relatives 

5 

26 

51 

44 

68 

89 

44 

48 

20 

29 

Physicians 

2 

I  I 

22 

23 

38 

33 

7 

20 

l6 

17 

Police 

54 

41 

47 

16 

25 

l4 

2 

20 

3 

7 

Hospitals 

2 

I 

6 

13 

3i 

7 

5 

9 

5 

8 

Former  employers 

17 

16 

12 

6 

1 1 

37 

3 

24 

4 

6 

Friends 

6 

12 

9 

13 

19 

18 

4 

13 

15 

15 

Teachers 

4i 

IO 

15 

2 

9 

17 

4 

42 

5 

5 

Clergymen 

5 

6 

16 

14 

3  1 

1 1 

2 

15 

27 

3 

Present  neighbors 

3 

5 

25 

3 

15 

3 

27 

2 

6 

Present  employers 

2 

4 

6 

6 

21 

5 

6 

8 

4 

2 

Marriage  records 

3 

3 

4 

40 

1 1 

7 

2 

9 

4 

Birth  records 

2 

36 

8 

3 

48 

8 

1 

3 

5 

2 

Former  neighbors 

1 

8 

12 

7 

30 

1 

5 

12 

4 

Dispensaries 

•  • 

1 

.  • 

3 

10 

2 

3 

1 

Medical-social  work 

1 

5 

16 

8 

1 

1 

3 

Former  landlords 

1 

3 

7 

9 

13 

19 

4 

7 

5 

3 

Courts 

1 

40 

12 

5 

17 

.  • 

•  • 

9 

3 

2 

Present  landlords 

2 

2 

5 

3 

17 

3 

1 

3 

1 

1 

Nurses 

•  • 

.  . 

•  . 

3 

22 

.  • 

2 

3 

2 

6 

Health  departments 

•  • 

3 

42 

1 

Lawyers 

2 

1 

6 

3 

7 

3 

4 

8 

3 

3 

Fellow  church  members 

2 

2 

•  • 

7 

1 

1 

1 

8 

1 

Medical  inspectors  and  nurses 

•  . 

7 

.  • 

1 1 

.  • 

Truant  officers 

1 

.  . 

6 

.  . 

3 

1 

1 1 

•  • 

Records  of  baptism 

1 

1 

32 

Prisons  or  reformatories 

2 

4 

7 

1 

.  . 

.  . 

Property  records 

.  . 

•  • 

•  • 

22 

•  • 

School  visitors 

•  . 

2 

.  . 

2 

.  . 

1 

4 

Present  tradesmen 

1 

5 

1 

Death  records 

2 

9 

6 

.  . 

1 

Fellow  pupils 

.  . 

1 

.  . 

1 

.  . 

2 

60 

Social  agencies 

30 

74 

83 

139 

129 

1 1 5 

52 

81 

57 

Other  sources 

3 

9 

24 

9 

43 

40 

19 

4 

5 

2 

Total 

180 

314 

394 

338 

801 

443 

187 

375 

203 

192 

470 


STATISTICS  OF  OUTSIDE  SOURCES 


CITY,  BY  AGENCIES  ENGAGED  IN  SPECIFIED  TYPES  OF  WORK 


Agencies  engaged  in 


Family  work 

Medical-social 

work 

Settlement 

worka 

Miscellaneous  work 

All  24 
agencies 

Public  out  door  relief 

Private  relief  society 

Relief  fund 

C.  0.  S.  suburban 

C.  0.  S.  city 

First  department 

Second  department 

Third  department 

First  settlement 

Second  settlement 

Adult  probation  work 

State  board  of  insanity 

State  commission  for 

the  blind 

Bureau  for  the  handi¬ 

capped 

42 

39 

44 

35 

3  6 

I  I 

6 

23 

5 

41 

19 

18 

2 

24 

769 

9 

32 

14 

26 

22 

72 

65 

22 

22 

34 

I 

21 

25 

10 

564 

5 

1 1 

.  . 

4 

4 

2 

•  . 

I 

5 

8 

89 

,  • 

.  . 

.  , 

358 

13 

78 

2 

8 

l6 

l6 

6 

58 

12 

17 

•  • 

22 

18 

4 

357 

2 

13 

l6 

3i 

31 

8 

. . 

8 

14 

24 

I 

12 

34 

330 

2 

18 

38 

1 

8 

3 

1 

6 

17 

32 

4 

8 

9 

3i 

302 

•  • 

38 

2 

7 

1 

4 

5 

4 

15 

33 

•  • 

14 

7 

280 

17 

34 

15 

16 

8 

5 

2 

4 

6 

10 

1 

3 

13 

264 

9 

18 

2 

1 

5 

2 

6 

7 

14 

19 

10 

•  • 

•  • 

182 

5 

14 

8 

1 1 

3 

1 

2 

1 

8 

6 

24 

147 

14 

17 

I 

.  . 

16 

.  . 

2 

2 

6 

1 

.  # 

1 

143 

6 

1 1 

•  • 

1 

•  . 

1 

.  . 

1 

1 

1 

1 

.  .  • 

.  . 

139 

9 

18 

*  • 

1 

•  • 

•  • 

.  . 

4 

•  . 

•7 

•  • 

2 

1 

132 

•  • 

46 

I 

5 

2 

3 

2 

.  . 

18 

23 

•  • 

1 

3 

124 

♦  • 

12 

9 

5 

8 

•  • 

3 

10 

29 

•  • 

9 

2 

122 

5 

12 

3 

2 

10 

,  , 

,  , 

.  # 

1 

7 

,  , 

#  # 

7 

1 18 

•  • 

7 

.  . 

1 

•  • 

2 

•  . 

.  . 

•  . 

7 

1 

•  • 

•  . 

107 

13 

1 1 

4 

5 

4 

3 

5 

1 

2 

6 

7 

I 

2 

4 

106 

6 

13 

•  . 

.  . 

8 

2 

8 

4 

3 

18 

.  . 

3 

s  . 

103 

•  • 

8 

6 

2 

2 

2 

•  • 

12 

2 

1 

•  • 

81 

1 

2 

4 

2 

2 

1 

4 

10 

2 

8 

76 

1 

35 

6 

•  • 

1 

1 

1 

.  . 

.  . 

7 

1 

76 

•  • 

5 

2 

3 

1 

3 

2 

3 

18 

20 

75 

18 

1 

.  . 

.  . 

1 

,  . 

21 

63 

2 

•  • 

•  • 

36 

2 

16 

1 

2 

.. 

1 

36 

•  • 

•  • 

1 

3 

1 

1 

.  . 

2 

2 

4 

36 

•  • 

4 

.  • 

.  . 

.  • 

.  . 

1 

20 

34 

2 

17 

1 

2 

2 

3i 

1 

9 

9  # 

#  # 

28 

•  . 

2 

.  . 

•  • 

.  . 

•  . 

•  • 

19 

25 

12 1 

178 

38 

5i 

74 

35 

64 

30 

27 

140 

13 

5 

41 

57 

1,694 

12 

30 

13 

5 

9 

5 

5 

3 

7 

33 

19 

42 

3 

13 

357 

298 

765 

213 

227 

280 

186 

184 

193 

202 

621 

►— « 

00 

's/I 

12  r 

145 

248 

7.295 

a  Special  work  chiefly  for  children  in  co-operation  with  the  schools,  juvenile  court, 
etc. 


471 


APPENDIX  III 


SPECIMEN  VARIABLE  SPELLINGS1 


Recorded  in  the  Social  Service  Exchange,  New  York.  (See 
Reference  to  Their  Use  on  P.  270  sq.) 


Abbott 

Anderson 

Barry 

Abad 

Andersen 

Barrie 

Abbette 

Andresen 

Bary 

Abbot 

Andreson 

Berry 

Abbotte 

Bailey 

De  Barry 

Adams 

Bailie 

Bauer 

Aadam 

Bailly 

Baier 

Adam 

Baillie 

Bauers 

Addams 

Baily 

Baur 

McAdam 

Baley 

Bour 

McAdams 

Bay  ley 

Bower 

Aiello 

Baylie 

Bowers 

Aeillo 

Bain 

Berger 

Aello 

Baine 

Barger 

Ahello 

Bane 

Bergher 

Aillo 

Bayen 

Bergor 

Ailo 

Bayne 

Borger 

Aiola 

Bean 

Burger 

Aiullo 

Ajello 

Beane 

Baldwin 

Bisella 

See  also  Pisella,  Basile, 

D  Aiello 

Baldwyn 

Bushell,  Buccolo 

Allen 

Balwin 

Barsila 

Alan 

Boldwin 

Basila 

Allan 

Barber 

Basili 

Allyn 

Barbour 

Basilia 

1  It  should  be  understood  that  the  exchange  in  any  city,  however  small,  would 
include  (i)  a  vastly  greater  number  of  real  names  than  are  given  here,  and  (2)  a 
very  large  number  of  misspellings  (among  foreign  names  especially)  due  to  un¬ 
familiarity  with  the  clients’  language  on  the  part  of  the  social  workers,  clerks, 
or  others,  who  interview  and  enquire  about  them.  Those  responsible  for  developing 
an  exchange  will  find  that  an  important  part  of  their  work  is  the  recording  of  such 
misspellings,  since  it  is  never  safe  to  assume  that  any  variation  from  the  real 
spelling,  however  wild,  may  not  be  repeated. 

472 


SPECIMEN  VARIABLE  SPELLINGS 


Bisella  (Continued) 

Basilio 

Basilla 

Basilo 

Basola 

Bassalla 

Bassili 

Bassilla 

Bassilo 

Basulli 

Bazalo 

Becella 

Besola 

Biasillo 

Biasoli 

Biselli 

Bissella 

Bissellee 

Bissilo 

Bocelli 

Borsella 

Bozella 

Bozzelli 

Bozzola 

Bucella 

Borofsky 

Barofsky 

Barowsky 

Berofesky 

Borodowsky 

Boroski 

Borosky 

Borovsky 

Borowsky 

Borufsky 

Boyle 

Boile 
Boyles 
O’ Boil 
O’ Boyle 

Brown 

Braun 

Broun 

Browne 

Browns 


Bryan 

Brian 

Brion 

Bryans 

Bryant 

Bryne 

Bryon 

Burke 

Berke 

Birke 

Burkes 

Burns 

Beirne 

Bern 

Berns 

Biern 

Birne 

Burn 

Burnes 

Byrne 

Byrnes 

Byrns 

Callahan 

Calahan 

Calihan 

Calligan 

Callihan 

Collihan 

Carl 

Carle 

Carll 

Carls 

Karl 

Karle 

Cavanagh 

Cavanaugh 

Kavanagh 

Kavanaugh 

Cohen 

Cohan 

Cohn 

Kohan 

Kohen 

Kohn 


Connell 

O’Connell 

Connelly 

Conley 

Connolly 

O’Connelly 

Connor 

Conner 

Conners 

Connors 

O’Connor 

O’Connors 

Cook 

Cooke 

Koch 

Kuch 

Cramer 

Kramer 

Daly 

Dailey 

Daily 

Daley 

Davidson 

Davidsen 

Davieson 

Davison 

Davis 

Davies 

Dixon 

Dickenson 

Dickerson 

Dickinson 

Dickson 

Dixson 

Dombrofsky 

Dambrosky 

Dandrosky 

Dembofsky 

Dombofsky 

Dombrodsky 

Dombroski 


473 


SOCIAL  DIAGNOSIS 


Donegan 

Doneghan 

Donigan 

Donnegan 

Donnigan 

Donogan 

Dunigan 

Dunnigan 

Donohue 

Donaghue 
Donahue 
Donnahue 
Donoghue 
O’ Donahue 

Donnelly 

Donelly 

Donley 

Donnally 

Donnely 

Donnolly 

Dougherty 

Daugherty 

Docherty 

Doherty 

Dorrity 

Duffy 

DufFee 

Duffey 

Duffie 

Eckardt 

Echardt 

Eckert 

Eckhart 

Ehhardt 

Evans 

Evan 

Evens 

Evins 

Ivans 

Fisher 

Fischer 


Fitzsimmons 

Fitzimmons 

Fitzimons 

Fitzsimons 

Flannigan 

Flanagan 
Flanigan 
Flannagan 
Flannegan 
O' Flanagan 

Flynn 

Flinn 

Fox 

Fuchs 

Frank 

Franc 

Franck 

Francke 

Franke 

Franks 

Fraser 

Fraiser 

Frasier 

Frazer 

Frazier 

Freizer 

Gablinsky 

Gabelisky 

Gablonsky 

Gabolensky 

Galinsky 

Galiski 

Galitzky 

Galizky 

Gallinski 

Gapalinsky 

Gobilinski 

Goliensky 

Golinsky 

Golitzky 

Kabalinsky 

Kalensky 

Kalinsky 

Kaliski 


Kalisky 

Kelinski 

Koblinsky 

Kolinski 

Kolinsky 

Kolisky 

Gardner 

Gardener 

Gardiner 

Gartner 

Gertner 

Gerrity 

Garaty 

Garety 

Garity 

Garrety 

Garrity 

Gearity 

Geraghty 

Gereghty 

Gerraghty 

Gerraty 

Gerrighty 

Giorlando 

Gerlando 

Giolando 

Gordon 

Gordan 

Gorden 

Gorton 

Gould 

Gold 

Golde 

Goldt 

Goold 

Gray 

Graye 

Grey 

Green 

Greene 

Grun 

Grunn 


474 


SPECIMEN  VARIABLE  SPELLINGS 


Griffin 

Greffin 

Griffen 

Griffins 

Guarantano 

Garantano 

Garatano 

Garetano 

Garetona 

Garratano 

Guamera 

Guamero 

Guaneri 

Guarmieri 

Guarnaro 

Guarneri 

Haggerty 

Hagarty 

Hagerty 

Haggarty 

Hegarty 

Heggerty 

Hogarty 

Hart 

Hardt 

Harte 

Hartt 

Hartz 

Harz 

Heart 

Herz 

Hertz 

Hayes 

Hay 

Haye 

Hays 

Healy 

Healey 

Heally 

Hines 

Heins 

Heinse 


Heinz 

Heinze 

Hynes 

Hoffman 

Haufman 

Hoffmann 

Hofmann 

Huffman 

Hogopian 

Agopian 

Der  Hagopian 

Hagasian 

Hagopian 

Hagopin 

Hajopian 

Hayopian 

Hoogosian 

Hughes 

Hewes 

Hughs 

Huse 

Irvin 

Ervin 

Ervine 

Erving 

Irvine 

Irving 

Irwin 

Johnson 

Jansen 

Janson 

Jensen 

Johansen 

Johnston 

Johnstone 

Jordan 

Jordain 

Jorden 

Jordon 

Kane 

Cain 

Caine 

Cane 

Canes 


Kain 

Kaine 

Kanes 

Kearney 

Carney 

Karney 

Kearny 

Kearns 

Kearn 

Kearnes 

Keirns 

Kern 

Kernes 

Kerns 

Kierns 

Kirn 

Kurns 

Kelly 

Kelley 

Kenny 

Kenney 
Kinney 
Me  Kenney 
McKinney 

Klein 

Cline 

Clines 

Clyne 

Clynes 

Klien 

Kline 

Kruger 

Cruger 

Krager 

Kreiger 

Kreuger 

Krugar 

Krugor 

Kurz 

Kertz 

Kirtz 

Kortz 

Kurtz 


475 


SOCIAL  DIAGNOSIS 


Lane 

Laine 

Lanes 

Layne 

Lehn 

Laughlin 

Loughlin 

O’Laughlin 

Lawlor 

Laulor 

Lawlar 

Lawler 

Lawrence 

Laurance 

Laurence 

Laurens 

Laurents 

Lorence 

Lorens 

Lorentz 

Lorenz 

Lee 

Lea 

Leigh 

Lenahan 

Lanahan 

Lenehan 

Lenihan 

Linahan 

Linehan 

Leonard 

Leighnard 

Lenart 

Lenhart 

Leonhard 

Leonhardt 

Lienhart 

Linhard 

Linhardt 

Linhart 

Levy 

Leavey 

Leavy 


Levey 

Levi 

Lewis 

Louis 

Luis 

Lowery 

Laurie 

Lawery 

Loughry 

Lowerie 

Lowrie 

Lowry 

Lynn 

Lenne 

Linn 

Linne 

McCarthy 

MacCarthy 

McCarthey 

McCartey 

McCartie 

McCarty 

McCormick 

MacCormick 

McCormack 

McCormic 

McCue 

MacCue 

McHugh 

McDonald 

MacDonald 

McDonell 

McDonnell 

McDonnold 

McEvoy 

McAvoy 

McVoy 

McGuire  . 

MacGuire 

Maguire 

McKay 

Mackay 

Mackey 

476 


Mackie 
McCay 
McKee 
Me  Key 

McKeon 

McKean 
Me  Keen 
McKeown 

Madison 

See  also  Matthewson 

Maddison 

Madsen 

Matheson 

Matison 

Matsen 

Matsin 

Matson 

Mattison 

Mattson 

Maher 

See  also  Meyer 

Mahar 

Mahr 

Marr 

Meagher 

Mahoney 

Mahony 
Mo  honey 
Mohony 
O’Mahoney 

Malloy 

Melloy 

Molloy 

Maloney 

Malaney 

Malony 

Malloney 

Moloney 

Mulaney 

Mullaney 

Meehan 

Mahon 

Meehen 

Mehan 


SPECIMEN  VARIABLE  SPELLINGS 


Meyer 

See  also  Maher 

Maier 

Mayer 

Mayers 

Meier 

Meyers 

Mier 

Miers 

Myer 

Myers 

Michael 

Mical 

Michaels 

Michel 

Michels 

Mickel 

Miller 

Meuller 

Millar 

Mollar 

Moller 

Moeller 

Mueller 

Muller 

Monahan 

Mannehan 

Monehan 

Monohan 

Moynihan 

Morrisey 

Morissey 

Morrissey 

Morrisy 

Mullen 

Millin 

Mullane 

Mullens 

Mullien 

Mullin 

Mullins 

Nelson 

Neilson 

Nielsen 


Nielson 

Nilson 

Nilsson 

Newman 

Neuman 

Neumann 

Numan 

Notafrancisco 

See  also  Francesco 
Notafrancesca 
Notarfrancesco 
Notrefrancesco 

O’Brien 

O’ Brian 

O’Bryan 

O’Bryen 

Olsen 

Ohlson 

Oleson 

Olson 

Olssen 

O’Neil 

O’Neal 

O’Neill 

O’Niel 

O’Niell 

Owens 

Owen 

Patterson 

Paterson 

Pattison 

Payne 

Pain 

Paine 

Pane 

Penn 

Petrasek 

Petracek 

Petresek 

Pietraseck 

Potucek 

Potuchek 

Ptracek 


Pollock 

See  also  Bullock 

Palak 

Palleck 

Pallick 

Pallock 

Pallok 

Paluch 

Paluck 

Parlik 

Paulick 

Paulik 

Pavelec 

Pavlick 

Pavlik 

Pawlek 

Pawlyk 

Peleck 

Polach 

Polack 

Polak 

Polich 

Pollack 

Poliak 

Polloch 

Pollok 

Polock 

Polyak 

Povlek 

Pulec 

Quinn 

Quann 

Queen 

Quin 

Quinne 

Reagan 

O’  Regan 

Reegan 

Regan 

Reed 

Read 

Reade 

Reeds 

Reid 

Wrede 


477 


SOCIAL  DIAGNOSIS 


Reilly 

O’Reilley 

O’Reilly 

Reilley 

Reily 

Rielly 

Riley 

Robinson 

Roberson 

Robertson 

Robeson 

Robison 

Robson 

Rogers 

Rodger 

Rodgers 

Schaefer 

Schaeffer 

Schafer 

Schaffer 

Scheaffer 

Schiefer 

Schiffer 

Shaefer 

Shaffer 

Schneider 

Schnider 

Schnyder 

Sneider 

Snyder 

Shea 

Schey 

Shay 

Sheay 

Smith 

Schmidt 

Schmitt 

Schmitz 

Smyth 

Sprovieri 

Sprofera 

Sprovira 


Sproviro 

Sprufera 

Stevens 

Stefan 

Steffens 

Stephan 

Stephen 

Stephens 

Stewart 

Stuart 

Thompson 

Thomsen 

Thomson 

Tierney 

Tarney 

Tearney 

Teirney 

Terney 

Tirney 

Trainor 
Tray  nor 
Treanor 

Ulrich 

Uhlrich 

Uhrich 

Ulrick 

Vano 

Vaina 

Vanna 

Vanni 

Vanyi 

Vena 

Viamio 

Viana 

Viane 

Viani 

Viania 

Viano 

Vierno 

Vaughan 

Vaughn 

478 


Vogel 

Fogel 
Van  Vogel 
Vogele 
Vogle 

Walsh 

Walsch 

Welch 

Welsch 

Welsh 

Webber 

Weber 

Weiber 

Wilson 

Willison 

Willson 

Wilsen 

Wolf  • 

Wolfe 

Wolff 

Woolf 

Wulff 

Worth 

Werth 

Wierth 

Wirth 

Wuerth 

Wishnofsky 

Wasnicky 

Wasnisky 

Wischnefsky 

Wischnewsky 

Wishnefsky 

Wishnewsky 

Wishnosky 

Wisneskey 

Wisnewska 

Wisnowski 

Wiszhnefsky 


SPECIMEN  VARIABLE  SPELLINGS 


Wynn 

Zack 

Ziegler 

Whyne 

Zach 

Seigler 

Winn 

Zacks 

Siegler 

Wynne 

Zaich 

Zeigler 

Young 

Zak 

Ziegeler 

Younge 

Zeak 

Zigler 

Youngs 

Zsak 

Yung 

479 


\  -  . 

'l 

BIBLIOGRAPHY 


3' 


BIBLIOGRAPHY 


I.  SOURCES 

As  explained  in  the  Preface  (p.  7),  there  have  been  two  main  sources  of  this  study: 
First,  a  large  number  of  social  case  histories  have  been  examined.  Second,  indi¬ 
vidual  case  workers  in  different  social  agencies  and  different  cities  have  been  inter¬ 
viewed. 

II.  REFERENCES 

There  is  no  bibliography  of  the  subject  of  investigation.  The  following  titles 
are  selected  from  the  references  made  throughout  this  book,  as  being  the  ones  most 
closely  related  to  its  theme: 

Balch,  Emily  Greene  (Associate  Professor  of  Economics  in  Wellesley  College). 
Our  Slavic  Fellow  Citizens.  536  p.  New  York,  Charities  Publication  Com¬ 
mittee,  1910. 

Baldwin,  James  Mark,  Ph.D.,  D.  Sc.  Oxon.,  LL.D.  Glasgow  (Professor  in  Prince¬ 
ton  University,  Co-editor  of  The  Psychological  Review).  Social  and  Ethical 
Interpretations  in  Mental  Development;  a  study  in  social  psychology.  606  p. 
New  York,  The  Macmillan  Company,  1902. 

Baldwin,  Roger  N.,  joint  author,  see  Flexner,  Bernard,  and  Baldwin,  R.  N. 
Birtwell,  Mary  L.  Investigation.  Pamphlet  published  by  the  Boston  Associated 
Charities  (No.  61),  1895. 

Bosanquet,  Helen.  The  Family.  344  p.  London,  Macmillan  and  Company, 
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Branthwaite,  R.  W.  Report  of  the  Inspector  under  the  Inebriates  Acts,  1879- 
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Byington,  Margaret  F.  The  Confidential  Exchange;  a  form  of  social  co-opera¬ 
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Cabot,  Richard  C.,  M.D.  Case  Teaching  in  Medicine.  214  p.  Boston,  D.  C. 
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Cannon,  Ida  M.,  R.N.  Social  Work  in  Hospitals;  a  contribution  to  progressive 
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Charity  Organization  Society,  London.  Occasional  Papers  of  the,  1896.  “How 
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Dubois,  Paul,  M.D.  (Professor  of  Neuropathology  in  the  University  of  Berne). 
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Flexner,  Bernard,  and  Baldwin,  Roger  N.  Juvenile  Courts  and  Probation.  308  p. 
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Little,  Brown,  and  Company,  1899. 

Gross,  Hans,  J.U.D.  (Professor  of  Criminal  Law  in  the  University  of  Graz,  Aus¬ 
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Langlois,  Charles  V.,  and  Seignobos,  Charles  (of  the  Sorbonne).  Introduction 
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Lawton,  Ruth  W.,  and  Murphy,  J.  Prentice.  “A  Study  of  Results  of  a  Child¬ 
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Mitchell,  S.  Weir,  M.D.,  LL.D.  Doctor  and  Patient.  Third  edition,  177  p. 
Philadelphia,  J.  B.  Lippincott  Company,  1898. 

Murphy,  J.  Prentice,  joint  author,  see  Lawton,  Ruth  W.,  and  Murphy,  J.  P. 

Putnam,  James  Jackson,  M.D.  “The  Treatment  of  Psychasthenia  from  the 
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Seignobos,  Charles  (of  the  Sorbonne),  joint  author,  see  Langlois,  Charles  V.,  and 
Seignobos,  C. 

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Little,  Brown,  and  Company,  1898. 

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Company,  1911. 

Turner,  C.  J.  Ribton-.  Suggestions  for  Systematic  Inquiry  into  the  Cases  of 
Applicants  for  Relief.  120  p.  London,  Knight  and  Company,  1872. 

Wigmore  John  Henry  (Professor  of  the  Law  of  Evidence  in  Northwestern  Uni¬ 
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General  Experience,  and  Illustrated  by  Judicial  Trials.  1 179  p.  Boston,  Little, 
Brown,  and  Company,  1913. 


485 


INDEX 


Accident  Cases:  dealings  with  employers 
in,  247-248 

Accounts,  Household:  problem  of  dealing 
with  housewife  who  cannot  keep,  148, 
149;  wilful  inaccuracies  in  keeping,  how 
shown,  150 

Accuracy  in  Witnesses:  tests  of,  summar¬ 
ized,  64 

Addresses:  of  employers,  use  of  city  direc¬ 
tory  in  making  more  accurate,  246;  ways 
of  getting  information  about,  through 
postal  authorities,  336 

Advice:  premature,  in  first  interview,  129- 
130;  queries  regarding  sources  of,  for  a 
widow’s  family,  404 

Affidavits,  Personal:  not  satisfactory  evi¬ 
dence  of  age,  257 

“ After-care  and  Prophylaxis:”  by  Adolf 
Meyer,  M.D.,  352 

Age:  a  matter  of  public  record,  123;  of  chil¬ 
dren,  reasons  for  knowing  exactly,  154- 
IS5;  ways  of  determining,  256-258 

Agents  for  Landlords:  as  sources  of  in¬ 
formation,  281 

Alcohol:  excessive  use  of,  and  inebriety, 
429;  queries  regarding  use  of,  for  an 
inebriate,  430,  431;  for  a  patient  pos¬ 
sibly  insane,  438 

Alcoholic:  employer’s  interest  in  case  of  an, 
242 

Alcoholism.  See  Inebriety 

American  Association  of  Societies  for 
Organizing  Charity:  suggestions  about 
foreign  correspondents  made  by,  326 

American  Statesman  who  “dealt  with  the 
facts”  criticised  by  N.  Y.  Evening  Post, 
55 

Americanization:  stages  in,  made  clear  in 
Woods’  Americans  in  Process,  386 

Americans  in  Process:  by  Robert  A.  Woods, 

299.  386 

Ames  Case:  inferences  drawn  from  face  card 
of,  83,  85;  face  card  of,  reproduced,  84; 
illustration  of  use  of  analogies  drawn 
from,  91 ;  illustrations  of  mistaken  causal 
relation  suggested  by,  92,  93;  summary 
of,  used  as  basis  for  criticism  of  diag¬ 
nostic  processes,  352-356,  361 

Amsden,  Mrs.  H.  S.,  10 

Analogy,  Mistaken:  as  source  of  error  in 
reasoning,  87,  91-92 

Analyses  of  First  Interviews:  made  by 
case  workers,  120,  121,  457-465 

Any  Family,  Questionnaire  regarding:  to 
precede  all  other  questionnaires,  374, 
378-381 


Appearance:  queries  regarding,  for  a  blind 
person,  421;  for  a  patient  possibly  in¬ 
sane,  441;  for  a  child  possibly  feeble¬ 
minded,  444 

“Applicant:”  substitution  of  “client”  for, 
in  this  book,  38;  former  methods  of  in¬ 
terviewing,  127 

Application  Blanks:  untrustworthy  wit¬ 
ness  of,  177,  318-319.  See  also  Blank 
Forms 

Application  of  Logic:  by  Alfred  Sidgwick,  87, 
97 

Application,  Origin  of:  as  affecting  method 
of  first  interview,  106 

Approach  in  First  Interview:  mode  of, 
quotation  from  Dr.  Adolf  Meyer  bearing 
upon,  1 15 

Aran  Islands:  by  John  Synge,  185 

Art:  experiences  of  fellow  practitioners  of 
value  to  practitioner  of  an,  103 

Assessors,  City:  consultations  with,  by 
social  agencies,  287 

Assets  for  Reconstruction:  should  be 
noted,  157;  place  of,  in  diagnostic  sum¬ 
mary,  360-361 

Associated  Charities.  See  Charity  Organ¬ 
ization  Societies 

Associated  Charities,  Boston:  consulta¬ 
tion  with,  by  users  of  the  confidential 
exchange,  308 

Association:  as  an  aid  to  memory,  68 

Assumptions:  of  social  worker,  risks  arising 
from,  95-96;  based  on  method  of  proba¬ 
bilities,  97 

A  tlantic  Monthly:  anonymous  contributor  to, 
quoted,  334 

Attendance:  school  evidence  regarding, 
225-226 

Attendance  Officers:  need  of  reorganiza¬ 
tion  of  task  of,  225 

Attention:  on  the  part  of  a  witness,  as 
affecting  his  testimony,  66-68 

Austin,  Mary,  96 

Averages:  habit  of  thinking  in,  96;  mean 
little  in  work  with  individuals,  163 

Ayer’s  annual  list  of  newspapers  published 
in  U.  S.,  269 

Ayres,  Leonard  P.,  202,  368 

Ayres,  Philip  W.,  31 

Baker,  Harvey  H.,  33 

Balch,  Emily  G.,  74.  75.  386 

Baldwin,  James  Mark,  369 

Baldwin,  R.  N.,  44,  45.  143 


489 


INDEX 


Bank  Accounts:  consultation  of,  264 

Banks,  Foreign:  as  means  of  establishing 
whereabouts,  261 

Baptism  Certificates:  use  of,  in  establish¬ 
ing  age,  256;  named  in  New  York’s  child 
labor  law,  257 

Baptism  Records:  consultation  of,  in  three 
cities,  255 ;  as  source  of  name  and  ad¬ 
dress  of  child’s  godparents,  262 

Bar  Mizvah  Certificates:  as  evidence  of 
age,  257 

Barker,  Lewellys  F.,  M.D.,  366 

Bedford,  Caroline  L.,  10 

Behavior:  school  evidence  as  to,  226 

Benefit  Societies:  as  one-headed  sources, 
175;  uses  of,  in  social  diagnosis,  290 

Betterment,  Individual  and  Mass:  inter¬ 
dependence  of,  25,  365,  366 

Bias:  risks  due  to,  in  testimonial  evidence, 
59.  60;  an  historian’s  tests  of,  summar¬ 
ized,  64;  racial  or  national,  73-75;  class, 
among  peasants,  74;  environmental,  75- 
76;  of  self-interest,  76-78;  of  self-esteem, 
79;  of  employers,  241 

Bible,  Family:  as  a  birth  record,  256,  257 

Bibliography:  for  this  volume,  plan  fol¬ 
lowed  in  making,  11 

Binet-Simon  Measuring  Scale,  34 

Birth:  queries  regarding,  for  a  patient  pos¬ 
sibly  insane,  437;  for  a  child  possibly 
feeble-minded,  443 

Birth  Certificates:  in  New  York  City, 
content  of,  256;  named  in  N.  Y.  child 
labor  law,  257;  foreign,  how  to  obtain, 
257 

Birth  Records:  failure  to  consult,  in  one 
city,  164;  consultation  of,  in  three  cities, 
255;  present  use  of,  illustrated,  256-257, 
259;  as  means  of  discovering  where¬ 
abouts,  260;  dates  to  be  searched  in 
looking  up,  271 

Birtwell,  Mary  L.,  31,  107,  268,  293,  325, 
337 

Blank  Forms:  use  of,  in  early  stages  of  in¬ 
vestigation,  127;  use  made  of,  by  three 
medical-social  workers,  128-129;  of  in¬ 
quiry,  addressed  to  dispensary  doctors, 
criticism  of,  208;  unsatisfactoriness  of, 
318-319.  See  also  Application  Blanks 

Blind  Person,  Questionnaire  regarding 

A,  420-424 

Blind,  Worker  for  the:  letters  to  priests 
and  parents  by,  331-332 

Blindness:  mistake  of  considering  fact  of, 
alone,  420;  queries  regarding  prevention 
of,  421 

Boarders:  in  immigrant  households,  com¬ 
plicate  study  of  food  problem,  149;  in¬ 
fluence  of,  should  be  considered  in  deser¬ 
tion  cases,  157.  See  also  Lodgers 

Boies,  Henry  M.,  285 

Bosanquet,  Helen,  139.  152,  368 

Boston:  influence  of  Octavia  Hill  in,  30; 
medical-social  work  in,  36;  use  of  con¬ 
fidential  exchange  data  by  agencies  in, 
308-310 


Boston  Associated  Charities:  consulta¬ 
tion  with,  by  users  of  confidential  ex¬ 
change,  308 

Boston  Children’s  Aid  Society:  interested 
in  probation,  33 

Boston  Municipal  Court:  separate  hear¬ 
ings  of  children’s  cases  in,  33 

Boston  School  for  Social  Workers:  help 
in  gathering  material  for  this  book  ren¬ 
dered  by,  10;  notes  on  conferences  of 
students  of,  on  uses  of  confidential  ex¬ 
change  data,  308-310 
Bosworth,  Marion,  88 
Bowker’s  Index  to  Dates  of  Current  Events,  269 
Brannick,  Catherine,  M.D.,  405 
Branthwaite,  R.  W.,  429,  430 

Braucher  Case:  as  illustrating  insight 
gained  from  relatives,  188-189;  series  of 
diagnoses  in,  356-357 
Breed,  Mary  I„  194,  195 
Brooklyn  Daily  Eagle:  index  to,  269 
Brooks,  Phillips,  10 

Brothers:  legal  responsibility  of,  for  sup¬ 
port,  in  different  states,  195 

Budget:  family,  wife  authority  on,  147,  149; 
food,  basis  for,  150 

Burden  of  Proof:  with  regard  to  unfavor¬ 
able  testimony  about  a  client,  59,  61,  62 

Burrows,  Sarah  F.,  282 
Business  Men:  letters  to,  331 
Business  Sources:  uses  of,  in  social  diag¬ 
nosis,  288-290 

Byington,  Margaret  F.,  10,  149,  304,  305. 
307,  308 


Cabot,  Richard  C.,  M.D.,  35,  49,  208,  212, 
214,  218,  347, 375, 376 

Cannon,  Ida  M.,  35 

Carstens,  C.  C.,  251 

Case  Committees:  as  critics,  348;  case 
workers’  summaries  to,  348 

Case  Histories:  mental  attitude  essential 
to  making  of  valuable,  99 

Case  Readers:  studies  made  for  this  volume 
by,  7 

Case  Summaries:  as  an  aid  in  obtaining 
medical  co-operation,  218 

Case  Teaching  in  Medicine:  by  Richard  C. 
Cabot,  M.D.,  347 

Case  Work:  clear  thinking  essential  to,  99 

Case  Work  Agency:  point  of  view  of  a, 
regarding  evidence,  contrasted  with  that 
of  S.  P.  C.  C.  and  court,  41-43 

Case  Work  Study:  fruitful  and  unfruitful 
methods  of,  375-376.  See  also  Social 
Case  Work 

Case  Workers.  See  Social  Workers 

Causal  Factors:  in  a  diagnostic  summary, 
360-361;  in  case  of  an  inebriate,  queries 
regarding,  431 

Causal  Relation,  Mistaken:  as  source  of 
error  in  reasoning,  87,  92-93 


490 


INDEX 


Causes  of  Poverty,  Crime,  etc.:  distin¬ 
guished  from  causal  factors  in  the  indi¬ 
vidual  case,  360 

Cavour:  Thayer’s  Life  of,  385 

Cemetery  Records:  use  of,  261 

Chalmers,  Thomas,  28,  29,  105 

Chapin,  R.  C.,  128 

Character:  queries  regarding,  for  a  person 
possibly  insane,  438^439;  for  a  child 
possibly  feeble-minded,  445 

Character  Evidence:  change  in  type  of, 
sought  by  social  workers,  61,  62 

Characteristics  of  Inhabitants:  of  native 
province,  etc.,  of  immigrant  groups, 
queries  regarding,  383 

“Characterology:”  understanding  of, 
needed  in  social  work,  56 

Charities  of  Springfield:  by  F.  H.  McLean,  221 

Charity  Office:  apology  of  man  for  not 
sending  wife  to,  143 

Charity  Organization  Campaigns:  for 
better  housing  and  for  prevention  of 
tuberculosis,  influence  upon  case  work  of, 
32 

Charity  Organization  Movement:  contri¬ 
bution  to  social  diagnosis  made  by,  27, 

28-33 

Charity  Organization  Societies:  no  meth¬ 
ods  or  aims  peculiar  to,  5 ;  case  work  op¬ 
portunities  offered  to  students  by,  32; 
workers  in,  said  by  S.  P.  C.  C.  worker  to 
need  training  in  weighing  evidence,  39; 
possible  assumptions  of  workers  in,  96; 
experience  of  a  worker  in  one  of,  com¬ 
pared  with  her  later  experience  as  agent 
of  state  department  for  care  of  children, 
105;  opinion  of  worker  in  one  of,  as  to 
place  of  first  interview,  108;  conditions 
of  first  interviews  in,  contrasted  with 
those  in  medical-social  work,  109;  direc¬ 
tion  to  “take  no  notes”  given  by,  127; 
included  in  statistical  study  of  outside 
sources,  16 1;  criticism  of  case  records  by 
secretary  of  one  of,  178;  statistics  of 
relatives  consulted  by  two,  180;  and 
other  agencies,  division  of  territory  be¬ 
tween,  296;  training  of  workers  in,  com¬ 
pared  with  that  of  settlement  workers, 
300;  character  of  some  agencies  which 
bear  name  of,  302;  relations  to  confi¬ 
dential  exchange  of,  304;  conception  of 
one  investigation  to  stand  for  all  time 
outgrown  by,  312;  reasons  for  dissatis¬ 
faction  of,  with  out-of-town  inquiries 
received,  321;  inadequate  letter  of  in¬ 
quiry  to,  cited,  328-329;  analysis  of  an 
interview  with  a  deserted  wife  by  worker 
in,  462-464 

Charity  Organization  Work,  Illustra¬ 
tions  from,  on:  need  of  developing 
diagnostic  skill  in  court  work,  45;  bias 
due  to  family  pride,  78;  first  interviews, 
1 17,  1 21;  experiences  in  dealing  with 
South  Italians  through  interpreters,  118, 
1 19;  relations  with  family  group,  140- 
142;  handling  of  an  illegitimacy  case, 
145;  treatment  of  two  young  couples, 
145;  failure  of  relatives  to  understand, 
183;  insight  gained  from  relatives,  188- 
189;  a  public  institution’s  carelessness 


in  the  matter  of  enforcing  support  from 
relatives,  196;  unwise  approach  to  rela¬ 
tives,  198;  conflicting  medical  prognoses, 
206,  207;  helpful  report  of  diagnosis  and 
prognosis  from  a  physician,  209;  help¬ 
ful  report  of  social  history  to  a  physician, 
209;  acceptance  of  hearsay  medical  evi¬ 
dence,  21S;  danger  of  medical  opinions 
from  non-medical  workers,  216;  uses  of 
school  evidence,  221,  222;  school  evi¬ 
dence  on  scholarship,  224;  unreliable 
employer  testimony,  241;  testimony 
from  an  employer,  243;  co-operation 
from  a  present  employer,  245;  securing 
information  about  an  Italian  laborer’s 
employment,  249;  need  of  search  for 
evidence  of  marriage,  258-259;  con¬ 
sultation  of  a  court  record,  262;  use  of  a 
hospital  record  to  establish  whereabouts, 
262;  concealment  of  property,  263-264; 
use  of  directories,  266-268;  use  of  pres¬ 
ent  neighborhood  sources,  275,  276;  use 
of  insurance  agents  as  a  source  of  in¬ 
formation,  289;  unexpected  results  from 
consulting  an  undertaker,  290;  hasty 
reporting,  350;  handling  of  a  case  by 
four  districts,  356-357 

Charity  Visitor,  The:  by  Amelia  Sears,  81,  88, 
89,  90,  155,  241,  249 

Chesley,  Annie  L.,  108,  190,  192,  197 

Chicago  Juvenile  Court:  applied  psychol¬ 
ogy  utilized  in,  33~34 

Chicago  School  of  Civics  and  Philan¬ 
thropy:  help  in  gathering  material  for 
this  book  tendered  by,  10 

Child-helping  Agencies:  possible  assump¬ 
tions  of  workers  in,  95,  96;  public  and 
private,  included  in  statistical  study  of 
outside  sources,  161;  illustration  of  non¬ 
social  attitude  on  part  of  a  hospital  fur¬ 
nished  by,  205;  illustration  of  teacher’s 
part  in  diagnosis  of  feeble-mindednes3 
furnished  by,  229;  instance  of  variable 
spellings  furnished  by,  271 

Child  Labor  Committee:  use  of  school  cen¬ 
sus  records  reported  by,  262 

Child  Labor  Legislation:  effect  on  case 
work  of,  32,  365.  See  also  New  York 
Child  Labor  Law 

Child,  Neglected,  Questionnaire  regard¬ 
ing  a,  405-412 

Child-placing  Agencies:  observations  of, 
as  evidence  regarding  feeble-mindedness, 
43;  possible  assumptions  of  workers  in, 
96;  need  of  knowing  family  histories  in 
work  of,  135;  public  and  private,  in¬ 
cluded  in  statistical  study  of  outside 
sources,  161;  consultations  with  relatives 
by,  180;  illustration  of  hearsay  medical 
evidence  obtained  by,  215;  consultations 
with  present  neighbors  by,  273;  special 
value  of  evidence  that  one  may  give 
another,  309 

Child-protective  Agencies.  See  Society  to 
Protect  Children  from  Cruelty 

Child-saving:  a  commonplace  of,  153.  See 
also  Child-helping  Agencies 

Child  Study:  the  approach  to  social  diag¬ 
nosis  by  way  of,  33 


INDEX 


Children:  excessive  suggestibility  of,  70; 
experience  in  a  first  interview  cited  by 
worker  with,  109;  causes  of  trouble  be¬ 
tween  parents  and,  140,  152,  153;  habit 
of  some  workers  of  dealing  with  family 
through,  153;  importance  of  confidences 
between  parents  and,  153 ;  failure  of  some 
family  agencies  to  individualize,  I53~i54; 
reasons  for  knowing  ages  of,  exactly,  154- 
155 ;  possible  explanations  of  long  periods 
between,  155;  older,  points  to  be  kept  in 
mind  in  dealing  with,  155-156;  grown, 
importance  of  interviews  with,  illus¬ 
trated,  156;  value  to,  of  comradeship  of 
grandparents,  157;  outside  sources  of 
information  most  used  in  work  with,  168 , 
169;  tendency  to  turn  over  to  care  of 
relatives,  185-186;  legal  responsibility  of , 
for  support,  195;  proof  of  marriage  as 
bearing  upon  protection  of,  259;  queries 
regarding  lack  of  control  of,  409-410; 
blind,  queries  regarding  special  educa¬ 
tion  of,  421;  of  a  person  possibly  insane, 
queries  regarding,  438 

Children,  Public  Department  for  Care 
of:  experience  of  agent  for,  compared 
with  her  earlier  experience  in  a  C.  O.  S., 
105;  opinion  of  agent  for,  as  to  place  of 
first  interview,  108;  account  of  first  in¬ 
terview  by  agent  for,  115;  consultation 
of  relatives  by,  180;  experience  of,  with 
relatives,  cited,  184;  illustration  of  co¬ 
operation  from  a  present  employer  re¬ 
ported  by,  245;  note  on  consultation  of 
birth  records  by,  256;  use  of  present 
neighbors  by,  273 

Children’s  Agency  :  illustration  showing  in¬ 
fluence  of  visitor  of,  70;  ways  of  dealing 
with  unmarried  or  deserting  fathers  illus¬ 
trated  by  notes  from,  144;  consultations 
with  school  sources  by,  221;  use  of  a 
former  residence  as  a  source  of  informa¬ 
tion  by,  279;  letters  of  a  worker  in,  332 

Children’s  Courts:  contributions  to  social 
diagnosis  made  by,  27,  33-34;  supple¬ 
ment  legal  evidence  by  social,  44.  See 
also  Juvenile  Court 

Children’s  Institutions:  testimony  of  one, 
regarding  defects  in  teachers’  evidence, 
232;  records  of,  as  evidence  of  age,  257; 
in  Pittsburgh,  investigations  by,  299; 
valuable  data  obtainable  from,  299 

Choosing  a  Vocation:  by  Frank  Parsons,  46 

Christian  and  Civic  Economy  of  Large  Towns: 
by  Thomas  Chalmers,  28 

Churches:  as  sources  of  information  in  three 
cities,  167;  as  one-headed  sources,  175; 
records  of  birth  in,  256;  consulted,  in 
2,800  cases  examined,  297,  298;  social 
evidence  of,  300-301.  See  also  Religious 
Affiliations 

Circumcision  Records:  as  evidence  of  age,v 
257 

Circumstantial  Evidence:  distinguished 
from  other  types  of  evidence,  56,  59,  60; 
direct  and  indirect,  trustworthiness  and 
value  of,  60 

City  Solicitor:  consultations  with,  by  social 
agencies,  287 

Civil  Lists:  as  sources  of  information,  266 


Class:  a  client  should  not  be  thought  of  as 
one  of  a,  97 

Class  Bias:  among  peasants,  74 

Clergymen:  as  witnesses,  300;  as  corre¬ 
spondents,  Miss  Birtwell  quoted  on,  325, 
326 

Clients:  term  defined  and  explained,  38; 
affairs  of,  not  necessarily  known  to  one 
referring  them  to  a  social  agency,  nor  to 
relatives,  65;  first,  unrehearsed  state¬ 
ments  of,  most  reliable,  69;  use  of  lead¬ 
ing  questions  in  dealing  with,  71-73; 
should  not  be  thought  of  as  one  of  a 
class,  97;  manner  of  application  of,  as 
affecting  first  interview,  106;  attitude  of, 
as  influencing  choice  of  place  of  first 
interview,  107,  109,  no;  importance  of 
knowing  recorded  experience  with,  before 
first  interview,  no,  in;  importance  of 
giving  a  fair  and  patient  hearing  to,  112, 
113,  114;  establishment  of  good  under¬ 
standing  with,  in  first  interview,  112,  113, 
114;  suggestions  from  physicians  bearing 
upon  mode  of  approach  to,  115, 116;  need 
of  grasping  personality  of,  in  first  inter¬ 
view,  126;  courtesy  toward,  should  de¬ 
termine  note- taking,  127;  attitude  of, 
toward  blank  form,  as  influencing  its  use 
by  medical-social  workers,  128;  ignor¬ 
ance  of  family  history  of,  as  cause  of  un¬ 
successful  treatment,  134,  135;  inter¬ 
views  with,  alone  and  in  presence  of  mem¬ 
bers  of  family,  136,  137;  present  situa¬ 
tion  of.  unduly  dwelt  upon  by  many 
agencies,  169;  sources  of  information 
nearest  to,  likely  to  prove  most  valuable, 
170;  objections  of,  to  having  relatives 
seen,  180;  relatives’  failure  to  under¬ 
stand,  illustrated,  183-186;  one  type  of, 
compared  to  Aran  Islanders,  185 ;  reasons 
for  studying  work  records  of,  236-238; 
statements  of,  to  be  compared  with  those 
of  employer,  239;  mis-statements  as  to 
wages  by,  illustrated,  246;  confidence  of, 
in  the  written  word,  254;  consultation  of 
records  to  secure  rights  of,  264;  impor¬ 
tance  of  social  worker’s  relations  to  other 
agencies  and  to,  compared,  294;  how  in¬ 
terests  of,  are  conserved  by  confidential 
exchange,  306-307;  injury  to,  by  dupli¬ 
cate  investigations,  311;  effect  upon,  of 
transfers,  314;  letters  of  inquiry  by,  326; 
letters  shown  by,  copies  of,  335;  letters 
regarding,  should  not  be  sent  by  hand  of, 
335;  original  letters  of,  as  evidence  of 
mentality,  education,  etc.,  335;  queries 
regarding  a  social  worker’s  relations  with, 
449.  See  also  Immigrants 

Clinical  Teaching  in  Medicine:  Dr.  Cabot 
quoted  on,  347 

“Clue  Blindness:”  a  remedy  for,  254 

Clues:  to  outside  information,  importance  of 
obtaining,  in  first  interview,  112,  113,  114; 
those  most  needed  in  first  interview,  124; 
obtaining  of,  in  emergency  interviews, 
131-132;  supplementary,  special  value  of, 
174-175;  supplementary,  to  former  em¬ 
ployers,  242;  furnished  by  death  records, 
258;  supplementary,  furnished  by  former 
neighbors,  279,  280 

Codman,  Julian:  66 

Coffee,  Overuse  of:  Dr.  Healy’s  findings 
regarding,  150 


492 


INDEX 


Colonies,  Foreign:  contact  of  parishioners 
and  clergy  in,  300;  value  of  advice  of 
leaders  in,  386 

Communication  with  Outside  Sources: 
various  means  of,  317 

Communion  Records,  First:  as  evidence  of 
age,  257 

Community:  of  an  unmarried  mother, 
queries  regarding,  414;  of  the  father  of 
her  child,  queries  regarding,  416 

Community  Customs:  in  native  country  of 
immigrant  groups,  queries  regarding,  384 

Comparison  of  Material:  suggestions  for 
the,  347-355 

Compensation.  See  Workmen’s  Compensa¬ 
tion 

Competence:  and  bias,  in  testimonial  evi¬ 
dence,  59,  60;  historians’  tests  of,  sum¬ 
marized,  64;  lack  of,  illustrated,  65,  66, 
67,  68 

Competitive  Stage  of  Social  Work,  293 

Conduct:  teachers’  evidence  as  to,  226;  uses 
of  records  of,  265 

Conferences  of  representatives  of  agencies 
on  difficult  cases,  315 

Confessions:  mistaken,  71 

Confidential  Exchange:  importance  of 
communicating  with,  before  and  after 
first  interview,  in;  beginnings  of,  294; 
need  of,  illustrated,  303-304;  history  and 
uses  of,  in  diagnosis,  304;  mechanism  of, 
described  by  Miss  Byington,  305-306; 
ensures  privacy  of  clients  by  limiting 
those  who  may  use,  306-307;  not  a 
benevolent  detective  agency,  307;  use  of 
data  furnished  by,  308-310;  misunder¬ 
standings  over  the  telephone  reported  by 
the  registrar  of,  340 

Confidential  Exchange,  The:  by  Margaret  F. 
Byington,  304,  305,  307,  308 

Confirmation  Records:  as  evidence  of  age, 
257 

Consuls,  Foreign:  illustrations  of  use  of,  288 

Consuls,  U.  S.:  consultations  with,  by  social 
agencies,  288;  use  of,  as  correspondents 
about  foreign  clients,  326 

Contagious  Disease  Records:  consulta¬ 
tion  of,  in  one  city,  255 

Contradictions:  between  witnesses  should 
lead  to  further  inquiry,  175-176;  in  evi¬ 
dence,  importance  of  looking  for,  350 

Control  of  Children,  Lack  of:  queries 
regarding,  409-410 

Controller,  State:  consultation  with,  by 
social  agencies,  287 

Cooley,  Charles  Horton,  4 

Co-operation:  principles  that  should  govern 
seeking  of  sources  rich  in,  170-172,  309; 
from  relatives,  illustrated,  189-194;  of 
employers,  illustrations  of,  242-246;  from 
unions  and  fellow  workmen,  instances  of, 
250;  in  social  work,  and  diagnosis,  292- 
293;  four  stages  in  development  of,  in 
U.  S.,  293 ;  third  stage  of,  294-295 ;  high¬ 
est  form  of,  295-296;  promoted  by  con¬ 
fidential  exchange,  304-310;  duplicate 
investigations  and,  31 1-3 13;  and  trans¬ 
fer  to  another  agency,  3 13-314;  being  as 


good  as  one’s  word  an  important  part  of, 
3i5 

Corrective  Defects:  in  a  child  possibly 
feeble-minded,  441-442 

Correspondence  on  Closed  Cases:  mistake 
of  destroying,  335 

Correspondent:  choice  of  the  best,  in  writ¬ 
ing  letters  of  inquiry,  323-326;  selected 
for  out-of-town  inquiry,  what  will  in¬ 
terest:  326-327;  what  sort  of  letter  of 
inquiry  will  save  unnecessary  trouble  to? 
327-331;  what  facts  relating  to,  should 
modify  approach  by  letter?  331-333 

Corroboration  of  Inferences,  85-87 

Couple,  Young  Married:  special  problems 
connected  with,  145 

Court,  Law:  point  of  view  of,  regarding  evi¬ 
dence,  contrasted  with  that  of  a  case 
work  agency,  41-43;  early  English, 
“vouching”  in,  52;  rejection  of  hearsay 
evidence  by,  57.  See  also  Children's 
Courts  and  Domestic  Relations  Court 

Court  Officials:  consultation  of  present 
neighbors  by,  275,  276,  277 

Court  Records:  consultation  of,  in  three 
cities,  255;  as  evidence  of  age,  257;  il¬ 
lustration  of  use  of,  in  establishing  where¬ 
abouts,  262;  types  of  work  hampered  by 
condition  of,  265 

Courtis,  Stuart  A.,  46 

“ Courtis  Tests  in  Arithmetic:”  by  Stuart  A. 
Courtis,  46 

Crime:  on  part  of  parents  of  a  person  pos¬ 
sibly  insane,  437 

Criminal  Investigation:  by  Hans  Gross,  9 

Criminal  Jurisprudence:  contributions  to, 
used  in  this  study,  49 

Criminal  Psychology:  by  Hans  Gross,  67,  68, 
1 16,  346,  349.  350 

Cruelty,  Physical  Injury  or  Abuse: 
queries  regarding,  410 

Culture:  in  native  country  of  immigrant 
group,  queries  regarding,  383-384 

Cutler,  Ruth,  88 

Dampness:  among  housing  defects  that  social 
workers  should  note,  15 1 

Day,  Mrs.  Hilbert  F.,  10,  435.  44i 

Day  Nurseries:  included  in  statistical  study 
of  outside  sources,  16 1;  consultations 
with  relatives  by  one,  180;  records  of,  as 
evidence  of  age,  257 

Deaconesses:  as  sources  of  information,  301 

Deaih  Records:  consultation  of,  in  one  city, 
255;  use  of,  258;  as  revealing  where¬ 
abouts,  260 

Debts:  inference  regarding  payment  of,  82, 
90,  91 

Definitions:  of  diagnosis,  51;  of  references, 
52;  of  witnesses,  52;  of  fact,  53;  of  evi¬ 
dence,  55;  of  inference,  55;  of  proof,  55 

Deland,  Lorin  F.,  284 

Delusions:  of  a  patient  possibly  insane, 
queries  regarding,  440 

Democracy:  individual  and  mass  activities 
in  a,  367-368 


493 


INDEX 


Denison,  Edward,  27 

Dependence:  inducement  of  chronic,  queries 
regarding,  410-41 1 

Deportation:  resources  of  home  country  as 
bearing  upon,  288;  provisions  regarding, 
in  Immigration  Law  of  1917,  393 

Deportment:  teachers’  evidence  as  to,  226 

Deserted  Family:  case  of  a,  reported  by 
Mrs.  Chesley,  190-192 

Deserted  Family  Questionnaire,  395~4oo 

Deserted  Wife:  analysis  of  interview  with 
a,  462-464 

Deserter:  C.  O.  S.  record  of,  comments  on, 
140-142;  a  children’s  society’s  dealings 
with,  144;  who  was  living  at  home,  case 
of,  reported  by  a  C.  O.  S.,  188;  connec¬ 
tions  often  maintained  by,  with  former 
surroundings,  251;  queries  regarding, 
396-399 

Desertion:  method  of  study  of  cases  of, 
146;  influence  of  relatives,  lodgers,  and 
boarders  should  be  considered  in  cases  of, 
157;  effect  of  throwing  responsibility 
upon  man’s  people  in  cases  of,  199;  as 
modifying  outline  of  a  work  record,  239- 
240;  proof  of  marriage  in  cases  of,  259; 
and  widowhood,  formerly  confused,  358- 
359,  395;  state  laws  regarding,  395;  pres¬ 
ent  and  past,  queries  regarding,  396-397 ; 
as  a  form  of  child  neglect,  queries  regard¬ 
ing,  408 

Detective  Manner:  to  be  avoided,  72 

Developmental  History:  of  a  child  pos¬ 
sibly  feeble-minded,  444 

Devine,  Edward  T.,  25,  31 

Diagnosis,  Medical:  beginning  to  show  in¬ 
fluence  of  social  evidence,  44;  writers  on, 
cited  in  this  book,  49;  conflicting,  illus¬ 
trated,  206;  early,  importance  of  and 
social  responsibility  for,  211;  written, 
advisability  of  seeking,  215;  should  be 
dated,  216;  mistake  of  suggesting,  when 
writing  to  a  physician,  331,  illustrated, 
335;  Dubois  quoted  on,  347;  inclusion 
of  social  context  in,  357;  of  insanity  or 
feeble-mindedness,  social  worker  should 
not  attempt  to  make,  434 

Diagnosis,  Social:  elements  of,  common  to 
all  types  of  case  work,  5 ;  wider  useful¬ 
ness  of,  6;  advantages  in  use  of  term,  26; 
uses  of,  26,  27;  contributions  to,  by  the 
charity  organization  movement,  27,  28- 
33;  contributions  to,  by  the  children’s 
court  movement,  27,  33-34;  contribu¬ 
tions  to,  by  the  medical-social  movement, 
27,  34-36;  defined,  51,  52;  would  be 
strengthened  by  habit  of  distinguishing 
hearsay  evidence,  57;  should  shun  small 
subterfuges,  72;  application  of  processes 
of  reasoning  to,  81-98;  sound  reasoning 
fundamental  in,  99;  four  processes  lead¬ 
ing  to,  103;  shaped  by  social  philosophy 
of  case  worker,  in;  importance  of 
promptness  in  making,  1 1 2 ;  importance  to, 
of  consultation  with  outside  sources,  160; 
division  of  labor  in,  176;  an  axiom  of, 
178;  reasoning  in  early  stages  leading  to, 
178;  two  purposes  of,  developed  in  con¬ 
sultations  with  employers,  238;  and 
co-operation,  292-293;  confidential  ex¬ 
change  promotes  better,  304;  duplicate 


investigations  and,  31 1-3 13;  fourth 
stage  leading  to,  342;  certain  aspects  of 
three  first  stages  in,  restated,  342-347; 
processes  by  which  arrived  at,  not  re¬ 
vealed  in  case  records,  348;  haste  and 
delay  in,  350,  355;  processes  of,  illus¬ 
trated  by  the  Ames  case,  352-356,  361; 
imaginative  insight  essential  to  success  in, 
355,  356;  redefined,  357;  as  an  adjunct 
to  medicine  and  psychology,  358;  con¬ 
tent  of  a,  358;  may  be  mistaken  or  a 
mere  classification,  358;  may  be  too  de¬ 
tailed,  or  partial,  359;  may  be  full  with¬ 
out  loss  of  clearness,  359~36o;  ways  of 
advancing  standards  in,  361,  362;  time 
element  in,  361-363;  not  always  possible 
to  make,  and  never  final,  363;  need  of, 
in  administrative  tasks,  365;  assumes 
more  importance  with  advances  in  social 
reform,  367 ;  requests  for  outline  to  cover 
any,  375;  lessons  in,  to  be  drawn  from 
Dr.  Cabot’s  Differential  Diagnosis,  376 

Diagnostic  Summary:  content  of,  360;  of 
the  Ames  case,  361 

Diagnostician,  Social:  two  essentials  of, 
98;  personality  of,  in  first  interview,  104. 
See  also  Social  Worker 

Dietitian:  experience  with  Polish  woman 
related  by,  149;  methods  employed  with 
mothers  receiving  pensions  reported  by, 
150 

Differential  Diagnosis:  by  Richard  C.  Cabot, 
M.D.,375 

Directories:  types  of,  265-266;  business, 
use  of,  266;  city,  uses  of,  126,  246,  265- 
268,  333;  of  social  agencies,  etc.,  as 
sources  of  information,  266;  professional, 
as  sources  of  information,  266;  telephone, 
use  of,  266’  trade,  as  sources  of  informa¬ 
tion,  266 

Disabilities:  and  the  questionnaire  plan,  8, 
9;  important  part  played  by  case  work¬ 
ers’  knowledge  of  and  attitude  toward, 
11 1;  the  questionnaire  as  a  device  for 
studying,  373-375,  377~378;  not  to  be 
treated  as  ultimate  causes,  395;  com¬ 
plicating  blindness,  420 

Discharge  Papers  of  Sailors:  evidence 
contained  in,  249 

Disease,  Medical  Histories  of:  Dr.  Cabot’s 
method  of  presenting,  in  Differential 
Diagnosis,  375 

Diseases:  in  which  early  medical  diagnosis 
is  of  especial  importance,  211;  of  a  per¬ 
son  possibly  insane,  queries  regarding, 
437-438 

Dispatch,  Telegraphic:  uses  of,  336-337 

Disposition:  of  a  person  possibly  insane, 
queries  regarding,  438-439;  of  a  child 
possibly  feeble-minded,  queries  regard¬ 
ing,  445 

District  Attorney:  consultations  with,  by 
social  agencies,  287 

Divorce  Records:  consultation  of,  in  one 
city,  255;  need  of  consulting,  illustrated, 
259 

Doctor  and  Patient:  by  S.  Weir  Mitchell, 
M.D.,  170 

Doctor  to  Doctor  is  more  frank,  216 

Doctors.  See  Physicians 


494 


INDEX 


Documentary  Evidence:  types  and  uses  of, 
61;  which  a  student  of  social  work  would 
find  to  exist  regarding  himself,  253 

Documents:  two  classes  of,  253;  in  which 
events  are  recorded  at  the  time  of  occur¬ 
rence,  more  reliable  than  memory,  254; 
when  most,  and  when  least,  satisfactory, 
254;  consultation  of,  in  2,800  cases 
studied,  255;  possibility  of  delegating 
task  of  consulting,  255;  method  in  con¬ 
sulting,  269-271 

Domestic  Relations  Court:  relations  of, 
with  social  work,  45 

Doyle,  Andrew,  28 

Doyle  Case:  comments  on,  140-142 

Drinking  Habits:  of  an  inebriate,  queries 
regarding,  431.  See  also  Alcohol 

Druggist:  as  a  witness,  275,  282 

Drugs:  queries  regarding  use  of,  by  an  in¬ 
ebriate,  431;  by  parents  of  a  patient  pos¬ 
sibly  insane,  436;  by  possibly  insane  pa¬ 
tient  himself,  438 

Drunkard,  Reformed:  no  longer  correct  to 
speak  of,  429 

Dubois,  Paul,  M.D.,  49,  116,  136,  347,  355 

Duncan,  Norman,  420 

Duplicate  Inquiry:  letters  of  social  workers 
making,  326 


Earnings:  evidence  regarding,  241;  in¬ 
stances  of  mis-statements  regarding,  by 
clients,  246;  inaccurate  statements  re¬ 
garding,  made  in  good  faith,  247.  See 
also  Financial  Situation 

Economic  and  more  comprehensive  approach 
to  social  diagnosis,  28 

Economic  Independence:  possible  assump¬ 
tions  regarding,  96 

Economic  Status:  inferences  as  to,  based  on 
part  of  house  occupied,  89 

Education:  social  diagnosis  to  become  an 
adjunct  in,  26;  bias  due  to  special,  75; 
queries  regarding,  for  any  family,  380; 
in  native  country  of  immigrant  group, 
383-384;  queries  regarding,  for  the  blind, 
422-423;  for  a  homeless  man,  426;  for 
a  patient  possibly  insane,  437 

Educators  recognizing  need  of  social  his¬ 
tories  of  pupils,  45 

Elberfeld:  poor  relief  system  in,  28 

Eliot,  Ada.  See  Sheffield,  Mrs.  Ada  Eliot 

Ellis  Island:  records  at,  likely  to  under¬ 
state  children’s  ages,  257 

Emergency  Interviews:  illustrations  of, 
131-132 

Emigration:  from  native  country,  province, 
and  town  of  immigrant  group,  queries 
regarding,  385;  of  an  immigrant  family, 
queries  regarding,  388-389 

Emotional  Condition:  of  a  patient  possibly 
insane,  queries  regarding,  440 

Employers:  not  competent  witnesses  as  to 
an  employe’s  home  conditions,  65-66; 
personal  as  contrasted  with  social  stan¬ 
dard  of  ethics  on  part  of,  76;  inference 
drawn  from  man’s  unwillingness  to  have 


worker  consult,  88 ;  better  witnesses  than 
his  family  to  a  man’s  habits,  123;  obtain¬ 
ing  information  regarding,  in  first  inter¬ 
view,  126;  as  sources  of  information  in 
three  cities,  167 ;  health  sources  consulted 
more  frequently  than,  204;  reasons  for 
unsatisfactory  results  of  consultations 
with,  235 ;  statements  of,  to  be  compared 
with  those  of  clients,  239;  testimony  of, 
value  and  certain  failures  of,  240-241; 
method  of  approach  to,  246-247;  deal¬ 
ings  with,  in  cases  of  accident,  247-248; 
substitution  of  a  developing  for  a  static 
program  in  dealing  with,  251.  See  also 
Employers,  Former,  Present,  and  Prospec¬ 
tive 

Employers,  Former:  reasons  for  consulting, 
238;  co-operation  of,  illustrated,  242- 
244;  letters  to,  331 

Employers,  Present:  reasons  for  consult¬ 
ing,  238;  dangers  involved  in  consulting, 
244;  co-operation  of,  illustrated,  245 

Employers,  Prospective:  may  create  con¬ 
ditions  for  investigation  by  experiment, 
236,  245;  relations  of  social  workers 
with,  238;  circumstances  under  which 
they  must  be  seen,  and  dangers  in  seeing, 
246 

Employment  Bureaus,  State:  consulta¬ 
tions  with,  by  social  agencies,  287 

Employment  Certificates.  See  Working 
Papers 

England:  beginnings  of  social  diagnosis  in, 
28 

Enlistment  Records,  Army  and  Navy:  use 
of,  as  means  of  locating  men,  260 

Environment:  bias  due  to,  75-76;  queries 
regarding,  for  any  family,  381;  for  a 
widow’s  family,  402 

Ethics:  personal  as  contrasted  with  social 
standard  of,  76 

Etiology:  of  a  child  possibly  feeble-minded, 
queries  regarding,  442 

Eugenic  Data:  obtaining  of,  from  relatives, 
186-187 

Eugenics  Record  Office:  general  terms  use 
of  which  is  warned  against  by,  349 

Eugenics  Work:  use  of  cemetery  records  in, 
261 

Everybody:  what  is  true  of,  375-377 

Evidence:  defined,  55;  types  of,  56-62; 
direct  and  indirect,  trustworthiness  of, 
60;  indirect,  cumulative  effect  of  items 
of,  60;  gathered  to  corroborate  or  dis¬ 
prove  a  theory,  value  of,  87;  importance 
of  ability  to  weigh  risks  involved  in 
different  types  of,  98;  items  of,  time  for 
considering  as  a  whole,  98;  total  of,  that 
reveals  no  plan  of  action,  shows  need  of 
further  inquiry,  176;  review  of  each  item 
of,  with  others  in  mind  and  excluded, 
349-350;  importance  of  looking  for  con¬ 
tradictions  in,  350.  See  also  Real,  Testi¬ 
monial,  Hearsay,  Circumstantial,  Docu¬ 
mentary,  Expert,  and  Character  Evidence, 
and  Oral  Testimony 

Evidence,  Legal:  social  evidence  differen¬ 
tiated  from,  39-43;  supplemented  by 
social  evidence  in  children’s  courts,  44 


495 


INDEX 


Evidence,  Social:  wider  usefulness  of,  6, 
43~So;  presentation  of  subject  of,  in 
this  book,  9;  differentiated  from  other 
kinds,  38-43;  may  include  facts  of  slight 
probative  value,  39;  need  of  social 
workers  for  training  in  use  of,  39 ;  defini¬ 
tions  bearing  upon,  51;  that  reveals  no 
plan  of  action,  176;  different  forms  of, 
177;  distinguishing  characteristic  of,  317 

“ Evils  of  Investigation  and  Relief by  Mrs. 
J.  S.  Lowell,  31 

Exchange,  Confidential.  See  Confidential 
Exchange 

Experience,  Recorded:  as  a  starting  point 
in  a  first  interview,  no 

Experiment:  importance  of,  in  social  work, 
284.  See  also  Investigation  by  Experi¬ 
ment 

Expert  Evidence:  advantage  and  disad¬ 
vantage  of,  61 

Expressmen:  as  witnesses,  289 

Extradition  of  Deserters:  state  laws  re¬ 
garding,  395 

Eyesight:  conservation  of,  queries  regarding, 
421 


Face  Card  :  experiment  of  drawing  inferences 
from,  83,  85;  of  Ames  family,  repro¬ 
duced,  84;  mistake  of  letting  first  inter¬ 
view  be  shaped  by,  122;  use  made  of,  by 
three  medical-social  workers,  128 

Facts:  and  unverified  statements,  confusion 
between,  illustrated,  S3;  defined,  53; 
and  inferences,  confusion  between,  illus¬ 
trated,  54;  difficulties  in  way  of  gather¬ 
ing,  54;  dealing  with,  a  delicate  process 
according  to  the  N.  Y.  Evening  Post,  55; 
importance  of  ability  to  discriminate  be¬ 
tween  inference  and,  98 

Faculties,  Co-ordination  of:  in  a  child 
possibly  feeble-minded,  queries  regard¬ 
ing,  446-447 

Family:  shifting,  inference  regarding,  81,  90; 
discussion  of  organization  of,  no  part  of 
plan  of  this  book,  134;  need  of  adjusting 
interests  of  individual  to  interests  of, 
136,  137;  the  united  and  the  unstable, 
139;  causes  of  estrangement  in,  140;  of 
a  young  able-bodied  man,  interference 
with,  145;  food  habits  of,  148-150; 
housing  of,  important  points  to  look  for 
in,  15 1 ;  what  is  possibly  true  of  any, 
377-381.  See  also  Any  Family ,  Ques¬ 
tionnaire  regarding 

Family,  The:  by  Helen  Bosanquet,  139,  152 

Family  Agencies:  possible  assumptions  of 
workers  in,  95;  changes  in  policy  of,  as 
to  place  of  first  interview,  106;  failure 
of,  to  individualize  children,  153;  con¬ 
sultations  with  school  sources  by,  221; 
use  of  present  neighbors  by,  273,  276 

Family  Group:  need  of  taking  into  account 
plans  and  ideals  of,  126;  need  of  taking 
into  account,  in  all  forms  of  social  work, 
134-137;  important  points  to  be  con¬ 
sidered  regarding  children  in,  152-156; 
influence  of  relatives  and  others  who  are 
members  of,  156-158;  queries  regarding 
social  worker’s  relations  with,  430 


Family  Life:  main  drift  of,  important  to 
grasp,  138-139;  in  native  country  of 
immigrant  groups,  queries  regarding, 
384;  queries  regarding,  for  an  immigrant 
family,  388;  of  parents  of  a  neglected 
child,  queries  regarding,  406-408 

Family  Pride:  collective  self-esteem  as,  78 

Family  Problems:  of  a  widow,  queries  re¬ 
garding,  402-403 

Family  Relationships:  re-establishment  of, 
as  result  of  social  work,  194-195 

Family  Solidarity:  possible  assumptions  re¬ 
garding,  96;  placing  of  children  away 
destroys  their  sense  of,  153 

Family  Work:  what  should  be  learned  in  first 
interview  in,  126;  outside  sources  of  in¬ 
formation  most  used  in,  168,  169 

Father:  unmarried,  ways  of  dealing  with, 
illustrated  by  case  notes,  144-145;  un¬ 
married,  queries  regarding,  416.  See 
also  Parents 

Feeble-minded  Child,  Questionnaire  re¬ 
garding  a  Possibly,  441-448 

Feeble-minded  ness:  evidence  regarding, 
furnished  by  social  agencies,  43,  44; 
school  evidence  regarding,  228-229; 
social  worker  should  not  attempt  to  make 
diagnosis  of,  434 

Fellow  Pupils:  consultation  of,  233 

Fernald,  W.  E.,  M.D.,  43,  44 

Fiction:  of  native  country  of  immigrant 
groups,  as  an  aid  to  study  of  them,  385 

Financial  Situation:  queries  regarding,  for 
any  family,  380;  for  a  deserted  fam¬ 
ily.  399-400;  for  a  widow’s  family,  404; 
for  a  blind  person,  423-424;  for  a  home¬ 
less  man,  426;  for  an  inebriate,  432 

First  Impressions:  lasting,  hence  need  of 
guarding  against,  350-351 

“Fixed  Order”  type  of  first  interview,  121. 
122 

Flexner,  Bernard,  44,  45,  143 

Flock,  The:  by  Mary  Austin,  96 

Folk  Ways:  of  native  country  of  immigrant 
groups,  poetry  and  legend  illustrating, 

385 

Food:  inference  regarding  minimum  amount 
a  family  can  live  on,  82,  86;  habits  of 
family  regarding,  importance  of,  and 
ways  of  getting  at,  148-150 

Footnotes:  in  this  volume,  why  cut  in  cer¬ 
tain  cases,  11 

Foreign  Correspondents:  choice  of,  326 

Foreign  Drafts:  as  means  of  establishing 
whereabouts,  261 

Foreign  Language  Press:  insights  to  be 
gained  from,  386 

Foreign  Neighborhoods:  value  of  advice 
of  leaders  in,  282,  386;  in  American 
cities,  contact  of  parishioners  and  clergy 
in,  300 

Foreigners:  workers  among,  sometimes  as¬ 
sume  that  immigration  is  a  menace,  95. 
See  also  Immigrants  and  Immigration 

Foremen:  value  of,  as  sources  of  information, 
247 


496 


INDEX 


Forewomen:  opportunity  of,  to  do  social 
work,  247 

Form:  used  in  gathering  statistics  of  outside 
sources,  466.  See  also  Blank  Forms 

“ Foundations  of  Educational  Achievement 
by  E.  L.  Thorndike,  369 

Foundling:  references  of  a,  163 

Fraternal  Orders:  as  sources  of  informa¬ 
tion,  290-291 

Friendly  Visiting  among  the  Poor:  by  M.  E. 
Richmond,  147 

Friends:  as  sources  of  information  in  three 
cities,  167 

Frost,  Robert,  296 

Funded  Thought:  defined  and  illustrated, 
66-68 


Galician  Farmers:  illiteracy  among,  89 

Gestation:  of  a  patient  possibly  insane,  437 ; 
of  a  child  possibly  feeble-minded,  443 

Girls’  Reformatory  Worker:  on  need  of 
new  investigations  in  certain  cases,  312; 
how  standards  were  advanced  by,  363 

Girls,  Society  for  Care  of:  illustration  of 
obtaining  medical  instructions  through 
a  physician  furnished  by,  217-218 

Goddard,  Henry  H.,  34 

Godparents:  in  certain  foreign  groups,  194; 
names  and  addresses  of,  on  baptismal 
records,  262 

Good  Faith:  tests  of,  in  witnesses,  summar¬ 
ized,  64 

Government:  in  native  country  of  immi¬ 
grant  group,  queries  regarding,  384 

Grade:  evidence  of  teachers  regarding,  223 

Graduation  Certificates:  named  in  N.  Y. 
child  labor  law  as  evidence  of  age,  257 

Grandparents  and  Grandchildren:  com¬ 
radeship  between,  157;  legal  responsi¬ 
bility  of,  for  support,  in  different  states, 
195 

Greenleaf,  Simon,  72 

Grocer:  as  a  witness,  282 

Gross,  Hans,  4,  9,  49,  66,  68,  116,  293,  346, 
349,  350 

Guardianship  Records:  consultation  of,  in 
one  city,  255 

Gurteen,  S.  H..  30 


Habits:  of  thought  of  social  workers,  that 
interfere  with  correct  inference,  96-98; 
queries  regarding,  for  a  person  possibly 
insane,  437-438;  for  a  child  possibly 
feeble-minded,  445 

Hallucinations:  of  a  patient  possibly  in¬ 
sane,  440 

Handbook  of  Charity  Organization:  by  S.  H. 
Gurteen,  30 

Handicaps.  See  Disabilities 

Hanus,  Paul  H.,  368 

Harvard  Medical  Students:  course  in 
medical-social  work  for,  36 

Health:  and  food  consumption,  149,  150; 
shifting  of  interest  from  occupations  to, 

32  497 


204;  queries  regarding,  for  any  family, 
379;  for  an  immigrant  family,  392-393; 
for  a  deserted  family,  399;  for  a  widow’s 
family,  402;  for  an  unmarried  mother, 
412;  for  a  blind  person,  421-422;  for  a 
homeless  man,  427-428;  for  an  inebriate, 
432;  for  a  patient  possibly  insane,  439- 
440;  for  a  child  possibly  feeble-minded, 
443-444.  See  also  Mental  Conditions 

Health  Agencies:  possible  assumptions  of 
workers  in,  96;  information  regarding, 
easily  obtained  in  first  interview,  125- 
126;  as  sources  of  information  in  three 
cities,  167 

Health  Department,  New  York  City: 
service  from,  reported  by  N.  Y.  C.  O.  S., 
210;  evidence  of  age  accepted  and  re¬ 
jected  by,  257-258 

Health  Workers.  See  Medical-social  Work 
and  Workers 

Healy,  William,  M.D.,  34,  117,  129,  136, 
137.  150,  153,  3i4,  375 

Hearsay  Evidence:  illustrations  of,  53,  58, 
77,  173-174,  21s,  279;  in  social  work  and 
in  the  law,  57;  employers’  testimony  on 
certain  matters  merely,  240-241;  social 
workers  too  likely  to  accept,  regarding 
property,  262 

Henderson,  Charles  R.,  28 

Heredity:  need  of  studying,  in  cases  of 
suspected  insanity,  187;  queries  regard¬ 
ing,  for  an  inebriate,  430;  for  a  patient 
possibly  insane,  436-437;  for  a  child  pos¬ 
sibly  feeble-minded,  442-443 

Higgins,  Alice.  See  Lothrop,  Mrs.  William  H. 

Hill,  Octavia,  29,  30,  34.  147,  370 

Hippocratic  Oath,  216-217 

Historians:  what  the  social  worker  can  learn 
from,  40,  49,  62;  summary  of  tests  of 
bias  and  competence  formulated  by,  64; 
attitude  of,  toward  hearsay  evidence,  57 

History:  importance  of  seeking  early  sources 
rich  in,  170-172,  309;  need  of,  illustrated 
by  one  unfortunate  case,  173- 174;  indi¬ 
vidual  and  family,  relatives  as  sources  of, 
186-187;  of  native  country  of  immi¬ 
grant  groups,  study  of,  advised,  385;  of 
immigrant  family,  prior  to  immigration, 
queries  regarding,  388;  of  a  patient  pos¬ 
sibly  insane,  queries  regarding,  436,  437. 
See  also  Industrial  History 

Home:  advantages  and  disadvantages  of 
holding  first  interview  in,  106-110;  need 
of  inquiring  into  conditions  of,  in  work 
with  children,  135;  analysis  of  a  first 
interview  in,  464-465;  school  evidence 
regarding  care  given  in,  229-230;  early, 
of  immigrant  family,  queries  regarding, 
387;  failure  to  provide  for,  queries  re¬ 
garding,  408;  of  an  unmarried  mother, 
queries  regarding,  414;  former  life  in, 
of  a  homeless  man,  queries  regarding, 
426;  of  a  child  possibly  feeble-minded, 
queries  regarding,  447 

Home  and  School  Visitors:  included  in 
statistical  study  of  outside  sources,  161; 
case  of  a  school  girl  with  St.  Vitus’s  dance 
reported  by,  227;  case  of  home  malad¬ 
justment  reported  by,  230;  utilization  of 
experience  of,  233 


INDEX 


Homeless  Man  Questionnaire,  425-428 

Homelessness:  as  modifying  outline  of  a 
work  record,  239-240 

Homemaking:  physical  aspects  of,  148-150 

Homes  of  the  London  Poor:  by  O.  Hill,  30 

Homestead:  by  M.  F.  Byington,  149 

Homicide:  attempted,  on  the  part  of  a  pa¬ 
tient  possibly  insane,  440 

Honesty:  by  William  Healy,  M.D.,  34,  150. 
153 

Hospitals:  advantages  and  disadvantages 
of  social  work  connected  with,  105,  106; 
non-medical  facts  recorded  by,  219; 
records  of,  as  evidence  of  age,  257;  rec¬ 
ords  of,  in  establishing  whereabouts,  261. 
See  also  Medical-social  Departments  and 
Medical-social  Workers 

Housekeepers,  Present:  comments  on  in¬ 
formation  gathered  from,  277 

Houses:  unfit  for  occupation,  persuading 
tenants  to  move  from,  152 

Housewife’s  Skill:  an  asset  to  be  included 
in  family  resources,  149 

Housing:  of  the  family,  important  points  to 
look  for  in,  151;  of  an  immigrant  family, 
queries  regarding,  392.  See  also  Environ¬ 
ment 

How  to  Obtain  Foreign  Birth  Certificates,  257 

“ How  to  Take  Down  a  Case:  ”  by  W.  G.  Mart- 
ley,  31 

Hull  House  Maps  and  Papers,  386 

Hull,  Ida,  73,  118 

Husband:  and  wife,  common  causes  of 
trouble  between,  140,  182;  place  of  inter¬ 
view  with,  143-144;  queries  regarding 
early  life  of,  for  desertion  cases,  397; 
queries  regarding  death  of,  for  use  in  a 
widow’s  family,  400 

Hutsinpillar,  Florence  W.,  247,  248,  250 

Hygiene,  Personal:  of  a  child  possibly 
feeble-minded,  448 

Hypotheses:  use  of,  in  investigation,  83,  85, 
86,  87,  99;  confirmation  of,  by  experi¬ 
ment,  86,  87;  resulting  from  use  of 
method  of  probabilities,  97;  danger  of 
becoming  attached  to  a  particular  one, 
98;  formed  during  two  first  interviews, 
120,  121 


“ Ideas  and  Ideals  in  Medicine:”  by  S.  J. 
Meltzer,  M.D.,  54 

Illiteracy:  inference  regarding  relation  be¬ 
tween  mental  ability  and,  89 

Illiterates:  communication  by  letter  with, 

324 

Illness:  queries  regarding,  in  case  of  a  per¬ 
son  possibly  insane,  439 

Imagination:  importance  of,  in  social  work, 

284 

Imagination  in  Business:  by  Lorin  F.  Deland, 

284 

“ Imbecile  with  Criminal  Instincts:”  by  W.  E. 
Fernald,  M.D.,  44 

Immigrant  Family  Questionnaire,  387- 
394 

498 


Immigrants:  silence  of  peasant,  68.  69;  class 
bias  among  peasant,  74;  maps  and  pic¬ 
tures  helpful  in  first  interviews  with,  118; 
difficulties  in  holding  interviews  with, 
1 18,  1 19;  conditions  affecting  family  co¬ 
hesion  among,  140;  presence  of  boarders 
in  families  of,  complicates  study  of  food 
problems,  149;  godparents  in  certain 
groups  of,  194;  lodge  doctor,  as  a  source 
of  information  regarding,  219;  how  to 
obtain  birth  certificates  of,  257;  diffi¬ 
culty  of  obtaining  property  data,  in  cer¬ 
tain  groups  of,  263 ;  spokesmen  of  groups 
of,  282;  deportation  of,  considerations 
bearing  upon,  288;  place  of  pastors  and 
priests  among,  300;  errors  that  case 
workers  may  fall  into  regarding,  382; 
suggestions  regarding  study  of  groups  of, 
383-386;  mistake  of  treating  merely  as 
immigrants,  386.  See  also  Workmen, 
Foreign,  and  Italians 

Immigration:  sometimes  assumed  by  city 
workers  to  be  a  menace,  95 ;  as  a  compli¬ 
cating  factor  in  consultations  with  rela¬ 
tives,  202;  of  groups  of  immigrants,  im¬ 
portance  of  history  of,  386 

Immigration  Law  of  1917:  provisions  re¬ 
garding  deportation  in,  393 

Immigration  Officials:  consultations  with, 
by  social  agencies,  288 

Immigration  Records:  consultation  of,  in 
three  cities,  255;  children’s  ages  as 
stated  in,  257;  information  contained  in 
and  ways  of  consulting,  264,  265 

Immorality:  as  a  justification  for  consulting 
present  neighbors,  275,  276,  277.  See 
also  Morality 

Income:  and  outgo,  wife  authority  on,  148; 
queries  regarding,  for  any  family,  380; 
for  a  widow’s  family,  404 

Index  Expurgatorius:  of  the  social  worker, 
349 

Index  to  this  Volume:  uses  of,  suggested, 382 

Individual:  interests  of  the,  need  of  adjust¬ 
ing  to  interests  of  family  as  well  as  of 
society,  136,  137 

Individual  Betterment:  and  mass  better¬ 
ment  interdependent,  25,  365,  366 

Individual  Delinquent:  by  William  Healy, 
M.D.,  34,  117,  129,  136,  314,  375 

Individual  Differences:  psychological  con¬ 
cept  of,  and  social  progress,  367-368 

Individuality:  by  E.  L.  Thorndike,  367 

Individualization:  of  the  inebriate,  impor¬ 
tant,  147;  of  children  by  family  agencies, 
often  omitted,  I53-I54 

Industrial  Capacity:  social  acquaintances 
as  witnesses  regarding,  66;  of  a  child 
possibly  feeble-minded,  queries  regard¬ 
ing,  447 

Industrial  Establishments:  personal  visits 
to,  as  compared  with  letters  or  telephone 
messages,  247 

Industrial  History:  queries  regarding,  for 
any  family,  379-380;  for  an  immigrant 
family,  389-390;  for  a  deserted  family, 
398-399;  for  a  widow’s  family,  401;  for 
an  unmarried  mother,  415,  417;  for  a 
homeless  man,  427;  for  a  patient  pos¬ 
sibly  insane,  438 


INDEX 


Industrial  Legislation:  influence  upon 
case  work  of,  32 

Industrial  Problems:  of  a  widow’s  family, 
queries  regarding,  403-404 

Industrial  School  at  Shirley:  suggesti¬ 
bility  of  boys  at,  70 

Industry:  social  diagnosis  to  become  an  ad¬ 
junct  in,  27;  varying  conditions  in  same, 
as  bearing  upon  case  treatment,  237-238 

Inebriate:  should  be  a  patient,  425,  429; 
success  in  treatment  of,  429 

Inebriety:  approach  to  study  of  problem  of, 
146,  147;  as  modifying  outline  of  a  work 
record,  239,  240;  defined  429 

Inebriety  Questionnaire,  430-433 

Inferences:  danger  of  confusing  with  facts* 
54;  importance  of,  in  diagnosis,  55;  de¬ 
fined,  81;  how  made,  81-85;  drawn  from 
face  card  of  Ames  family,  83,  85;  how 
corroborated,  85-87;  often  miscalled  in¬ 
tuitions,  86;  errors  in,  due  to  mistaken 
general  rule,  88-90;  errors  in,  due  to 
mistaken  particular  case,  90-91;  errors 
in,  due  to  mistaken  analogy,  91-92;  er¬ 
rors  in,  due  to  mistaken  causal  relation, 
92-93 ;  errors  in,  due  to  thinker’s  predis¬ 
positions,  94;  errors  in,  due  to  thinker’s 
assumptions,  95-96;  errors  in,  due  to 
mental  habits  of  thinker,  96-98;  impor¬ 
tance  of  ability  to  discriminate  between 
fact  and,  98;  illustrations  of,  furnished 
by  two  first  interviews,  120,  121;  illus¬ 
tration  of  invalid,  due  to  desire  of  worker 
to  secure  prompt  action,  350 

Injuries:  to  a  person  possibly  insane,  queries 
regarding,  437-438 

Inquiry:  narrowing  and  broadening  of,  in 
different  types  of  interview,  343;  wider 
aspects  of,  35 1-352,  453;  as  a  whole, 
queries  regarding,  451-453 

Insane  Person:  terms  in  which  activities  of, 
should  be  described,  435 

Insane,  Questionnaire  regarding  a  Pa¬ 
tient  Possibly,  436-441 

Insanity:  as  a  justification  for  the  consulting 
of  present  neighbors,  275,  276,  277;  so¬ 
cial  worker  should  not  attempt  to  make 
diagnosis  of,  434;  previous  attacks  of, 
in  case  of  a  patient  possibly  insane,  439. 
See  also  Mental  Disease 

Insanity  Commitment  Records:  consulta¬ 
tion  of,  in  one  city,  255 

Insanity,  State  Board  of:  consultations 
with,  by  social  agencies,  287 

Insight:  relatives  as  sources  of,  188 

Institution  Worker:  possible  assumptions 
of,  96 

Institutional  Work  for  Children:  need 
of  inquiry  into  home  conditions  in,  135 

Institutions:  public,  carelessness  of,  in  en¬ 
forcing  responsibility  upon  relatives,  195- 
196;  ability  of,  to  supply  experience  data 
regarding  inmates,  297;  bias  to  be  al¬ 
lowed  for  in  testimony  of,  299 

Insurance  Agents  :  as  a  source  of  informa¬ 
tion,  289 

Insurance  Policies:  as  evidence  of  a  child’s 
age,  257 


Insurance  Records:  consultation  of,  in  one 
city,  255 

Intellectual  Capacity:  of  a  child  possibly 
feeble-minded,  446 

Intellectual  Defects  :  of  a  patient  possibly 
insane,  440-441 

Intellectual  Status:  of  a  homeless  man, 
queries  regarding,  428 

Intermediaries:  letters  of  inquiry  addressed 
to,  and  answers  from,  323-326 

Interpretation:  defined,  103;  of  material 
in  diagnosis,  355-363 

Interpreters:  difficulties  in  using,  illus¬ 
trated,  75;  Italian,  Miss  Ida  Hull  quoted 
on  use  of,  118-119 

Interview,  First:  part  of  diagnostician’s 
task  in  which  personality  counts  for  most, 
104;  as  modified  by  the  nature  of  the 
task,  104;  as  modified  by  the  origin  of 
the  application,  106;  as  modified  by  the 
place  of  the  interview,  106-110;  as  modi¬ 
fied  by  the  recorded  experience  available 
as  a  starting  point,  no;  scope  of,  m- 
114;  objects  of,  114;  the  approach  in, 
1x5-119;  illustrations  of  successful,  116, 
1 17;  clues  and  questions  in  the,  120-126; 
analyses  of,  by  case  workers,  120,  12 1, 
457-465;  two  types  of,  121,  122,  123; 
taking  notes  in,  126-129;  premature  ad¬ 
vice  and  promises  in,  129-130;  tests  of 
success  of,  130;  bringing  to  a  close,  130- 
131;  emergency,  131-132;  report  from  a 
medical-social  department  of  a,  135-136 

Interviews:  best  method  of  approach,  177; 
with  outside  sources,  essentials  of  method 
in,  178;  with  employers,  as  compared 
with  letters  and  telephone  messages,  247 ; 
main  reliance  of  social  worker,  317-318; 
advances  in  art  of  conducting,  319; 
methods  common  to  all,  restated,  342- 
343;  changes  of  emphasis  in  different 
types  of,  343-344 

Introduction  to  the  Study  of  History:  by  Lang- 
lois  and  Seignobos,  49,  57,  64,  68,  69 

Intuitions:  mistake  in  applying  term  to 
rapid  inferences,  86 

Investigation:  and  social  diagnosis,  26,  51, 
52;  first  attempts  to  introduce,  28,  29; 
described  as  repressive,  30;  not  to  be 
regarded  as  an  end  in  itself,  3 1 :  inference 
passes  through  various  degrees  of  cer¬ 
tainty  during,  83;  drawing  inferences 
from  face  card  approximates  mental 
processes  in,  83;  methods  that  make  for 
success  in,  112,  113;  use  of  interpreters 
in,  1 19;  early  methods  of,  127;  Le  Play 
quoted  as  to  his  method  of,  128;  object 
of,  130;  by  visiting  present  neighbors, 
justification  of,  274,  276;  quality  of, 

where  co-operation  lacking,  292;  dupli¬ 
cate,  and  co-operation,  3 1 1 ;  before  trans¬ 
fer  to  another  agency,  extent  of,  3 13-3 14; 
and  plan,  lack  of  connection  between, 
348;  flaws  in,  revealed  by  summaries  to 
case  committees,  348;  need  of  guarding 
against  effect  of  first  and  last  statements 
in,  350-351 

Investigation  by  Experiment,  86,  87,  236, 
245.  297,  299 

“Investigation:"  by  M.  L.  Birtwell,  31,  107 


499 


INDEX 


Investigators:  who  prided  themselves  on 
catching  client  tripping,  72;  Dr.  Adolf 
Meyer’s  advice  to,  quoted,  434-435 

Irishman,  Unnaturalized:  inferences  as  to 
an,  86,  98 

Italians:  traits  of  a  group  of,  73,  74;  diffi¬ 
culty  in  testing  willingness  to  work  of, 
86;  use  of  interpreters  with,  118-119; 
wives  of,  often  known  by  maiden  name, 
147;  ways  of  getting  information  about 
employment  of,  249;  illustrations  of  con¬ 
cealment  of  property  among,  263-264; 
concealment  of  relatives  by,  289.  See 
also  Immigrants 

Janitresses:  comments  on  witness  of,  277 

Joint  Traffic  Agreements:  in  social  work, 

294 

Jowett,  Benjamin,  138 

Judgment:  ability  to  form  and  to  suspend, 
355 

Jurisprudence:  social  diagnosis  to  become 
an  adjunct  in,  26 

Juvenile  Court:  consultations  with  rela¬ 
tives  by,  180;  estrangement  from  chil¬ 
dren  caused  by  parents’  complaints  to, 
152;  intervention  of,  rendered  unneces¬ 
sary  by  other  measures  in  certain  cases, 
314.  See  also  Children’s  Court,  Chicago 
Juvenile  Court 

Juvenile  Court  Law  in  Chicago  secured,  33 

Juvenile  Courts  and  Probation:  by  Flexner  and 
Baldwin,  45,  143 

Juvenile  Delinquents:  Dr.  Healy  on 
method  of  interviewing,  117,  129;  con¬ 
fidences  between  elders  and  children  in 
relation  to,  153;  Dr.  Healy’s  method  in 
study  of,  375 

Kingsley,  Charles,  349 

Labor  :  signs  of  change  in  methods  of  dealing 
with,  235-236 

Labor,  State  Department  of:  consultation 
with,  by  social  agencies,  287 

Labor  Union.  See  Trade  Union 

Laborers,  Day:  ways  of  getting  information 
about,  249 

La  Methode  Sociale:  by  Le  Play,  128 

Landlords:  direct  appeals  to,  sometimes 
effective  in  remedying  abuses,  152 

Landlords,  Former  and  Present:  use  of, 
in  three  cities,  273;  uses  of,  and  dangers 
in  consulting,  280-282 

Langlois,  Charles  V.,  49,  57.  64,  68,  69,  79, 
173 

Lattimore,  Florence  L.,  135.  194.  299 

Law:  social  case  work  should  profit  by  ex¬ 
perience  of,  40.  See  also  Court 

Law  School  Graduate:  criticism  of  case 
records  made  by  a,  59 

Lawrence,  L.  K.,  124 

Laws:  in  native  country  of  immigrant  group, 
queries  regarding,  384 

Lawton,  Ruth  W.,  135 

Lawyer:  what  the  social  worker  can  learn 
from  the,  62 


Layman’s  Handbook  of  Medicine:  by  Richard 
C.  Cabot,  M.D.,  212 

Leading  Questions:  dangers  and  uses  of, 
explained  and  illustrated,  71-73;  in  first 
interviews,  123 

Lee,  Joseph,  292 

Lee,  Porter  R.,  136 

Legal  Aid  Society:  case  illustrating  need  of 
search  for  marriage  record  reported  by, 
259 

Legends:  of  native  country  of  immigrant 
groups,  as  an  aid  to  study  of  them,  385 

Legislation,  Housing:  reporting  defects  in 
relation  to,  15 1 

Legislation,  Social:  effect  of,  upon  case 
work,  365,  366 

Legitimacy:  proof  of  marriage  as  bearing 
upon  questions  pf,  259 

Le  Play,  P.  G.  F.,  128,  139 

Letter  Carriers:  forbidden  to  give  infor¬ 
mation  about  addresses,  336 

Letters:  as  evidence,  177;  compared  with 
other  means  of  communication  with  em¬ 
ployers,  247 ;  of  endorsement  accompany¬ 
ing  blank  forms,  319;  “to  whom  it  may 
concern,”  335;  about  client,  mistake  of 
sending  by  him,  335;  shown  by  client, 
preservation  of  copies  of,  335;  on  closed 
cases,  mistake  of  destroying,  335;  origi¬ 
nals  of,  as  an  evidence  of  mental  disease, 
education,  etc.,  335;  registered,  as  a  de¬ 
vice  for  establishing  whereabouts,  336. 
See  also  Letters  of  Inquiry  and  Letters 
of  Reply  to  Inquiries 

Letters  of  Inquiry:  example  of  one  written 
prematurely,  174.  3 21-322;  two  classes 
of,  319;  questions  that  case  worker 
should  ask  himself  before  writing,  320; 
should  they  be  written  at  all?  320; 
should  they  be  written  now?  321-322; 
what  relation  does  the  particular  inquiry 
bear  to  the  whole  process?  322;  choice 
of  the  best  correspondent  for  the  end  in 
view,  323-326;  what  will  interest  cor¬ 
respondent  selected?  326-327;  examples 
of  unfortunate,  327;  presentation  that 
will  save  correspondent  unnecessary 
trouble,  327-331;  examples  of  poor,  329; 
example  of  good,  330;  what  facts  re¬ 
lating  to  correspondence  should  modify? 
331-333;  circular,  uses  of,  335 

Letters  of  Reply  to  Inquiries:  faults  of, 
333-334 

Levin,  L.  H.,  58,  262 

Liabilities:  place  of,  in  diagnostic  sum¬ 
mary,  360,  361 

Librarians:  of  children’s  rooms,  233;  as  a 
possible  source  of  information,  287 

Life  and  Times  of  Cavour:  by  Wm.  R.  Thayer, 

385 

Lithuanian  Peasants:  silence  of,  69 

Lodge  Doctor:  as  a  source  of  information 
about  foreign  families,  219 

Lodgers:  influence  of,  should  be  considered 
in  desertion  cases,  157;  queries  regard¬ 
ing,  for  an  immigrant  family,  392;  for 
a  deserted  family,  398,  399;  for  a  widow’s 
family,  403 


500 


INDEX 


Logic:  books  on,  of  use  in  this  study,  49; 
application  of,  in  experimentation,  87. 
See  also  Reasoning 

London:  work  of  Octavia  Hill  in,  30 

London  Charity  Organization  Society: 
early  tendencies  in,  29;  Occasional  Papers 
of  the,  31 

Lothrop,  Mrs.  William  H.,  262,  337 
Lowell,  Mrs.  Josephine  Shaw,  27,  31 


Mack,  Julian  W.,  34 

Maiden  Name:  importance  of  knowing 
wife’s,  147;  Italian  wives  sometimes 
known  by,  147 

Man  of  Family:  should  be  seen,  143 

Manifest  Sheets:  as  evidence  of  age,  257 

Maps:  value  of,  in  first  interviews  with  im¬ 
migrants,  1 18 

Marriage:  inference  drawn  from  unreadi¬ 
ness  to  give  date  and  place  of,  88;  under 
an  assumed  name,  case  of,  259;  queries 
regarding,  for  an  immigrant  family,  388; 
for  a  person  possibly  insane,  438 

Marriage  Records:  failure  to  consult,  a 
sign  of  weakness  in  technique,  164;  con¬ 
sultation  of,  in  three  cities,  255;  points 
to  be  kept  in  mind  regarding,  258-259; 
as  revealing  whereabouts,  260;  illustra¬ 
tion  of  use  of  one,  to  establish  where¬ 
abouts,  262;  dates  to  be  searched  in 
looking  up,  271 

Married  Life:  queries  regarding,  for  de¬ 
sertion  cases,  398-399;  for  a  widow  with 
children,  401 

Masonic  Fraternity:  relations  to  social 
workers  of,  290-291 

Mass,  Condition  of:  social  workers  often 
oppressed  by,  97 

Mass  Betterment:  and  individual  better¬ 
ment  interdependent,  25,  365 

Massachusetts:  state  visiting  agency  in¬ 
terested  in  probation,  33 

Massachusetts  Commission  on  Minimum 
Wage  Boards,  237 

Massachusetts  General  Hospital:  origin 
of  social  service  department  of,  35 ;  course 
in  medical-social  work  for  medical  stu¬ 
dents  at,  36 

Massachusetts  S  P.  C.  C.:  reasons  for 
knowing  exact  ages  of  children  stated 
by  secretary  of,  155 

Maurice,  C.  E  ,  30 

McLean,  Francis  H.,  6,  10,  175,  221,  280, 
282,  302 

Medical  and  Social  Data:  complementary 
nature  of,  207-2 11 

Medical  Care,  Neglect  to  Provide: 
queries  regarding,  408-409 

Medical  Evidence:  failures  in,  due  to  non¬ 
social  attitude,  205;  failures  in,  due  to 
conflicting  diagnoses  and  prognoses,  206, 
207 

Medical  Records:  faults  of,  207 


Medical  Report:  of  diagnosis  and  prog¬ 
nosis,  example  of  helpful,  209 

Medical  Science  and  Practice:  parallel 
between  social  work  and,  366 

Medical-social  Department:  illustration 
of  use  of  leading  question  by  worker  in, 
72;  illustration  of  employer’s  biased  testi¬ 
mony  given  by,  76;  report  from,  regard¬ 
ing  a  first  interview  where  plan  made 
without  seeing  man,  135;  included  in 
statistical  study  of  outside  sources,  161; 
outside  sources  of  information  most 
used  in  work  of,  168,  169;  consultations 
with  relatives  by,  180;  conflicting  diag¬ 
noses  in  a  case  under  care  of,  206;  illus¬ 
tration  of  complementary  nature  of 
medical  and  social  data  furnished  by, 
208;  example  of  better  diagnosis  ob¬ 
tained  through  a  physician  as  inter¬ 
mediary,  furnished  by,  217;  a  teacher’s 
evidence  regarding  an  hysterical  child 
reported  by,  227;  instances  of  co-opera¬ 
tion  from  unions  reported  by,  250;  use 
of  voting  list  reported  by,  260;  instance 
of  use  of  present  neighbors  in  an  insanity 
case  by,  277;  use  of  sporting  editor  of  a 
paper  as  a  source  of  information  reported 
by,  290;  experience  with  masonic  lodge 
reported  by,  291;  instance  of  biased 
testimony  of  an  institution  supplied  by, 
299;  failure  of,  to  consult  agency  to 
which  client  had  been  transferred,  314; 
use  of  registered  letter  to  find  mother  of 
patient  by,  336;  report  of,  regarding 
unfortunate  results  of  use  of  telephone, 
339;  misunderstanding  over  the  tele¬ 
phone  reported  by,  340;  analysis  of  in¬ 
terviews  with  patient  in,  457-461.  See 
also  Medical-social  Workers 

Medical-social  Movement:  contributions 
to  social  diagnosis  made  by,  27,  34-36 

Medical-social  Workers:  quotations  from, 
as  to  place  of  first  interview,  108,  109; 
different  methods  of  two,  in  first  inter¬ 
views,  123;  differing  use  of  blank  forms 
by,  128-129;  thinking  of  family  as  a 
whole  important  for,  136;  way  of  getting 
insight  into  relations  between  members 
of  family  reported  by,  153;  instructions 
of,  to  new  assistants,  216;  importance 
of  obtaining  evidence  of  marriage  illus¬ 
trated  by,  259;  cited  on  need  of  new  in¬ 
vestigations  in  certain  cases,  312 

Medical  Sources:  frequency  of  consulta¬ 
tion  with,  204;  kinds  of,  most  often  con¬ 
sulted,  205;  importance  of  asking  for 
prognosis  when  consulting,  2 13 ;  economy 
of  resources  in  consulting,  2 13-2 15;  need 
of  consulting  at  first  hand,  215;  summa¬ 
ries  and  reports  as  means  of  strengthen¬ 
ing  relations  with,  218;  miscellaneous 
suggestions  as  to  consulting,  219 

Medical  Treatment:  of  an  inebriate, 
queries  regarding,  431 

Medicine:  social  diagnosis  to  become  an 
adjunct  in,  26;  contributions  of  social 
work  to,  44;  Dr.  Cabot’s  handbook  of, 
for  laymen,  212;  social  diagnosis  as  an 
adjunct  to,  358 

Meltzer,  S.  J.,  M.D.,  49,  54,  55 

Memoirs,  Personal:  weakness  of,  68 


501 


INDEX 


Memory:  as  affecting  the  competence  of  wit¬ 
nesses,  68-69;  importance  of  training  of, 
in  interviewing  without  taking  notes, 
127;  documents  of  original  entry,  as  cor¬ 
rectives  for,  254;  queries  regarding  de¬ 
fects  of,  in  a  patient  possibly  insane,  440- 
441 

Mental  Ability:  inference  as  to  relation  be¬ 
tween  illiteracy  and,  89 

Mental  Conditions:  school  evidence  re¬ 
garding,  227-229;  queries  regarding,  for 
any  family,  379;  for  a  widow’s  family, 
402;  for  a  homeless  man,  427;  for  parents 
of  a  patient  possibly  insane,  436;  for  the 
patient  himself,  439,  440 

Mental  Defect:  inferences  from  illiteracy 
and  retardation  as  to,  89.  See  also  Feeble¬ 
mindedness 

Mental  Disease:  unfamiliarity  of  unedu¬ 
cated  witnesses  with  symptoms  of,  67; 
need  of  studying  family  history  in  cases 
of  suspected,  187;  letters  as  an  evidence 
of,  335;  diagnosed  as  unemployment  due 
to  laziness,  358;  social  worker’s  contri¬ 
bution  to  study  of ,  434.  See  also  I nsanity 

Mental  History:  of  men  written  in  their 
social  relations,  136 

Mental  Hygiene  Movement:  influence 
upon  case  work  of,  32 

Mental  States:  inclusion  of  social  context 
in  diagnosis  of,  357 

Method  of  Probabilities:  Sidgwick  quoted 
on,  97 

Methods:  used  in  this  study,  6-9;  of  social 
worker  that  mean  narrowed  resourceful¬ 
ness,  96;  in  first  interview,  104,  112-113, 
1 15-132;  of  investigation  employed  by 
Le  Play,  128;  in  visiting  outside  sources 
of  information,  176-178;  of  approach  to 
relatives,  198,  200-202;  of  consulting 
medical  sources,  213-219;  of  consulting 
school  sources,  232-233;  of  approach  to 
employers,  246-249;  in  consultation  of 
documents,  269-271;  common  to  all  in¬ 
terviews,  342-344;  of  case  work  study, 
fruitful  and  unfruitful,  375~376 

Meyer,  Adolf,  M.D.,  114,  131,  218,  352, 
362,  434 

Midwives’  Records  of  births,  256 

Minister.  See  Clergymen 

Minority  Report  of  English  Poor  Law  Com¬ 
mission,  Part  II,  237 

Mitchell,  S.  Weir,  M.D.,  49,  170 

Money:  economies  in,  call  for  increased  out¬ 
lay  in  skill  and  work,  149 

Montessori,  Marie,  45 

Morality:  queries  regarding,  for  a  deserted 
family,  399;  for  family  of  a  neglected 
child,  408,  409,  410;  for  an  unmarried 
mother  and  the  father  of  her  child,  415, 
416,  417,  418;  for  a  homeless  man,  428- 
429;  for  the  parents  of  a  patient  possibly 
insane,  436;  for  the  patient  himself,  441; 
for  a  child  possibly  feeble-minded,  445 

Mother,  Unmarried:  of  second  child,  for¬ 
merly  assumed  to  be  hopelessly  degraded, 
95 ;  mistake  to  communicate  with  father 
of  child  through,  144;  case  of,  reported 
by  Mrs.  Chesley,  190-192;  formerly  con¬ 


fused  with  widow  and  deserted  wife,  358- 
359.  See  also  Questionnaire  regarding  an 
Unmarried  Mother 

Mothers.  See  also  Parents,  Wife,  and  Widow 

Mothers’  Pensions:  methods  employed  by 
a  dietitian  administering,  150 

Moving  Van  Number:  as  a  clue  in  discover¬ 
ing  whereabouts,  289 

Murphy,  J.  Prentice,  135 

National  or  Racial  Bias  of  witnesses,  73-75 

Native  Country  of  Immigrants:  sugges¬ 
tions  regarding  study  of,  383-386 

Naturalization:  failure  to  seek  as  basis  for 
inference,  86 

Naturalization  Papers:  father’s,  as  evi¬ 
dence  of  a  child’s  age,  257 

Naval  Training  Station,  U.  S.:  circular 
letter  to  parents  of  apprentice  seamen  by, 
198 

Navy  Department:  consultations  with,  by 
social  agencies,  288 

Needs:  of  an  immigrant  family,  queries  re¬ 
garding,  393 

Neff,  Irwin  H.,  M.D.,  147,  430 

Neglect  of  Children:  points  of  view  of 
case  work  agency  and  court  as  to  evi¬ 
dence  regarding,  41-43;  school  evidence 
regarding,  222,  229-230;  queries  regard¬ 
ing  particular  form  of,  408-411;  queries 
regarding  general  aspects  of,  411-412 

Neglected  Child,  Questionnaire  regard¬ 
ing  A,  405-412 

Neighborhood  Evidence:  compared  with 
other  types,  273 

Neighborhoods:  previous,  obtaining  infor¬ 
mation  regarding,  in  first  interviews,  126; 
present,  significance  of  frequent  use  of 
sources  belonging  to,  164,  167 

Neighbors:  former,  use  of,  in  three  cities, 
273;  present,  use  of,  in  three  cities,  273; 
present,  dangers  and  uses  of,  274-278; 
former,  dangers  and  uses  of,  as  witnesses, 
278-280 

Nervous  Disorders:  of  parents  of  a  patient 
possibly  insane,  queries  regarding,  436 

New  York  Charity  Organization  Society: 
work  of  committee  to  prevent  tubercu¬ 
losis  of,  35;  service  rendered  by  N.  Y.  C. 
Department  of  Health  to,  210;  speci¬ 
mens  of  variable  spellings  in  social  service 
exchange  of,  270,  472-479 

New  York  Child  Labor  Law:  documentary 
evidence  of  age  named  in,  257 

New  York  City:  social  workers  in,  25  ; 
items  covered  by  birth  certificates  in,  256 

New  York  City  Bureau  of  Records:  pho¬ 
tographic  copies  of  records  made  by,  270 

New  York  City  Death  Certificate:  data 
called  for  by,  258 

New  York  City  Health  Department:  ser¬ 
vices  of,  reported  by  N.  Y.  C.  O.  S.,  210; 
evidence  of  age  accepted  and  rejected  by, 
257-258 

New  York  Evening  Post:  quoted  in  criticism 
of  a  statesman  who  “dealt  with  the 
facts,”  55 


502 


INDEX 


New  York  Hospitals:  non-medical  facts 
recorded  by,  219 

New  York  Public  Library:  news  indices  on 
shelves  of,  listed,  269 

New  York  School  of  Philanthropy:  data 
prepared  for  this  volume  used  by  author 
when  Kennedy  lecturer  of,  10;  pamphlet 
of,  cited,  25;  organization  of,  31 

New  York  State  Charities  Aid  Associa¬ 
tion,  30 

New  York  State  Factory  Investigating 
Commission,  Fourth  Report,  237 

New  York  Times:  index  to,  269 

New  York  Tribune:  index  to,  269 

News  Indices:  list  of,  269 

Newsboys,  City  Superintendent  of:  con¬ 
sultations  with,  by  social  agencies,  287 

Newspaper  Files:  made  accessible  by  cer¬ 
tain  indices,  269 

Newspapers,  Foreign  Language:  insights 
to  be  gained  from,  386 

Non-support  Cases:  importance  of  present 
employer  testimony  in,  244 

North  of  Boston:  by  Robert  Frost,  296 

Notation  of  Recurrence:  a  duty  of  case 
worker  and  supervisor,  352 

Note-taking  in  the  first  interview,  126-129 

No-thoroughfare  Situations:  call  for  fur¬ 
ther  inquiry,  176 

Nurses:  habit  of  some,  of  dealing  with  fami¬ 
lies  only  through  children,  153;  mis¬ 
taken  diagnosis  by  one,  358 


Objects  of  First  Interview:  summarized, 
1 14 

Observations,  First-hand:  of  employer, 
more  valuable  than  his  inferences,  243 

Observers:  and  witnesses,  contrasted,  52 

Occasional  Papers  of  the  London  Charity  Or¬ 
ganization  Society,  31 

Occupations:  queries  regarding,  for  any 
family,  379-380;  in  native  country  of  an 
immigrant  group,  383;  for  an  immigrant 
family,  389-390,  393;  for  a  deserted 
family,  397,  398,  399;  for  a  widow’s 
family,  403-404;  for  family  of  a  neglected 
child,  406-407;  for  an  unmarried  mother, 
415,  417;  for  a  blind  person,  423;  for  a 
homeless  man,  427;  for  a  person  possibly 
insane,  438 

Offenders,  First:  as  subjects  for  probation, 

91 

Office  Interview:  advantages  and  disad¬ 
vantages  of,  106-110 

One  Thousand  Homeless  Men:  by  Alice  W. 
Solenberger,  73,  425 

Oral  Testimony:  main  reliance  of  social 
diagnostician,  61;  strength  and  weak¬ 
ness  of,  317 

Our  Slavic  Fellow  Citizens:  by  Emily  G. 
Balch,  75,  386 

Outgo:  queries  regarding,  for  any  family, 
380;  for  a  widow’s  family,  404 

Outline  of  a  work  record,  239 


Out-of-town  Inquiries:  reasons  for  dissat¬ 
isfaction  with,  321;  plans  for  centralized 
handling  of,  327 

Overcrowding:  inference  regarding,  81,  86; 
points  regarding,  which  social  workers 
should  have  in  mind,  151 

Overseer  of  the  Poor:  good  reporting  by 
an,  310;  failure  to  grasp  r61e  of  interme¬ 
diary  by  an,  324 


Parents:  legal  responsibility  of,  for  support 
of  children,  195 ;  queries  regarding,  for  an 
immigrant  family,  387;  for  a  patient  pos¬ 
sibly  insane,  436 

Parsons,  Frank,  46 

Particular  Case,  Mistaken:  as  source  of 
error  in  reasoning,  87,  90-91 

Passing  On:  as  a  method  of  charitable  relief, 
337 

Passports:  use  of,  in  three  cities,  255;  as 
evidence  of  age,  256;  named  in  New  York 
child  labor  law,  257;  data  needed  for 
identification  of  immigrant  upon,  265 

Pathological  History:  of  a  child  possibly 
feeble-minded,  443-444 

Pathological  Lying:  need  of  co-operation 
in  the  home  when  treating,  137 

Pathological  Lying,  Accusation,  and  Swin¬ 
dling:  by  William  Healy,  M.D.,  137 

Patrolmen.  See  Police 

Peasants:  silence  of,  68,  69;  class  bias 
among,  74 

Peculiarities  of  a  child  possibly  feeble¬ 
minded,  444,  446 

Pedagogical  Anthropology:  by  Marie  Montes- 
sori,  45 

Penal  Commissioners,  State:  consultations 
with,  by  social  agencies,  287 

Pendleton,  Helen  B.,  13 i 

Pension  Bureau,  U.  S.:  data  needed  to 
obtain  reports  on  pensioners  from,  264 

Personality:  inside  truths  of,  need  to  be 
grasped  in  first  interview,  126 

Philosophy:  of  case  worker  shapes  every 
process  leading  to  diagnosis,  1  x  1 ;  under¬ 
lying  case  work,  365-370 

Physical  Conditions:  school  evidence  as  to, 
227 

Physical  Conditions,  Defects,  Changes, 
History,  etc.  :  queries  regarding,  for  any 
family,  379;  for  an  immigrant  family, 
392;  for  a  deserted  family,  399;  for  a 
widow’s  family,  402;  for  a  neglected 
child  and  its  family,  406,  408,  409;  for  a 
blind  person,  421-422;  for  a  homeless 
man,  427-428;  for  an  inebriate,  431;  for 
the  parents  of  a  patient  possibly  insane, 
436;  for  the  patient  himself,  437-438, 
439-440;  for  a  child  possibly  feeble¬ 
minded,  443 

Physicians:  can  throw  direct  light  on  social 
worker’s  problems,  62;  information  re¬ 
garding,  in  first  interview,  125-126;  as 
sources  of  information  in  three  cities,  167; 
examples  of  helpful  reports  to  and  hw 
209;  importance  of  asking  for  progr^ta~ 
from,  213;  economy  of  resources  nev 


503 


INDEX 


Physicians  ( continued ) 

by  social  workers  in  dealing  with,  2 13-21 5 ; 
antagonized  by  medical  opinions  from  the 
non-medical,  216;  fuller  reports  often 
obtained  from,  by  fellow  practitioners, 
216-217;  as  witnesses  on  non-medical 
matters,  219;  records  of  birth  kept  by, 
256;  private,  statements  of,  as  evidence 
of  age,  257;  letters  of  inquiry  to,  331 

Pictures:  useful  in  first  interviews  with  im¬ 
migrants,  1 18 

“ Pittsburgh  as  a  Foster  Mother:”  by  Florence 
L.  Lattimore,  135.  194.  299 

Plans:  premature,  in  first  interviews,  130; 
queries  regarding,  for  any  family,  381; 
for  an  immigrant  family,  391;  for  a 
deserted  family,  397;  for  a  widow’s 
family,  403,  404;  for  an  unmarried 
mother,  419;  for  a  homeless  man,  428; 
for  an  inebriate,  432-433;  for  a  child 
possibly  feeble-minded,  448 

Play  in  Education:  by  Joseph  Lee,  292 

Playground  and  Recreation  Directors: 
utilization  of  experience  of,  233 

Poetry:  illustrating  folk  ways  in  native 
country  of  immigrant  groups,  385 

Poles:  attitude  of,  toward  Russians,  75; 
estimate  of  cost  of  food  for  her  family  by 
a  Polish  woman,  149 

Police  Departments:  lost  and  found  bu¬ 
reaus  of,  261 

Police  Officials:  bias  on  part  of,  as  seen  by 
a  probation  officer,  75 ;  differences  in  use 
of,  as  sources  of  information  in  three 
cities,  167;  as  witnesses,  uses  of,  285- 
287;  one  quoted  on  unsatisfactoriness  of 
letters,  317-318 

Police  Precinct  Book:  use  of,  as  a  source 
of  information,  261 

Poor  Relief  System  in  Elberfeld:  by  A.  Doyle, 
28 

Positions  in  Social  Work:  by  E.  T.  Devine 
and  Mary  Van  Kleeck,  25 

Postmasters:  consultations  with,  by  social 
agencies,  288;  use  of,  as  sources  of  in¬ 
formation,  336 

Poverty,  Causes  of:  distinguished  from 
causal  factors  in  the  particular  case,  360 

Predispositions  of  Social  Worker:  risks 
arising  from,  94,  98 

Prejudices  of  Social  Worker:  may  influ¬ 
ence  judgment,  97 

Preliminary  Treatise  on  Evidence  at  the  Com¬ 
mon  Law:  by  James  B.  Thayer,  49,  56, 
269 

Prenatal  History:  of  a  patient  possibly  in¬ 
sane,  437;  of  a  child  possibly  feeble¬ 
minded,  443 

Pressure  of  Work:  influence  of,  upon  social 
diagnosis,  and  how  it  may  be  overcome, 
361-363 

Preventive  Measures:  promotion  of,  an 
important  part  of  charity  organization 
work,  32-33;  and  transfer  among  agen¬ 
cies,  3 13-3 14 

Priests:  letters  to,  by  a  worker  for  the  blind, 
31-332 

ipaLs.  See  Teachers 


Principles  governing  choice  of  sources  of 
information  outside  family  group,  169- 
176 

Principles  of  Judicial  Proof:  by  J.  H.  Wig- 
more,  49,  68,  69,  305 

Printers'  Ink:  advertiser  writing  in,  quoted, 
54 

Prisoners  and  Paupers:  by  Henry  M.  Boies, 
285 

Prisoners,  Work  for:  hampered  by  condi¬ 
tion  of  court  records,  265 

Probabilities,  Method  of:  should  not  be 
used  if  it  is  possible  to  get  the  facts,  97 

Probation:  first  offenders  as  subjects  for,  91 

Probation  Officer:  illustration  showing  in¬ 
fluence  of,  70;  illustration  of  bias  on  part 
of  police  given  by,  75 ;  experience  of, 
with  girl  shoplifters,  77-78;  method  of, 
in  first  interview,  modified  by  nature  of 
task,  105;  often  fails  to  see  fathers  of 
children,  143;  tells  of  girl  who  held 
grudge  against  mother,  152;  experience 
of,  with  relatives,  cited,  184;  case  of  co¬ 
operation  from  relatives  reported  by, 
193-194;  report  of,  regarding  a  teacher’s 
evidence  on  feeble-mindedness,  226;  ad¬ 
vantages  of  early  visit  to  school  reported 
by,  232;  need  of  care  in  consulting  em¬ 
ployers  reported  by,  244;  quoted  on  use 
of  present  neighbors,  274;  use  of  present 
neighbors  in  a  court  case  reported  by, 
277;  quoted  on  value  of  police  in  social 
work,  285;  case  of  girl  who  gave  false 
name  reported  by,  318;  instance  of  self¬ 
supervision  by,  349-350 

Probation  Work,  Adult:  included  in  sta¬ 
tistical  study  of  outside  sources,  16 1; 
use  of  present  neighbors  in,  273 

Probation  Work,  Juvenile:  origin  of,  33; 
included  in  statistical  study  of  outside 
sources,  161;  no  study  of,  possible  in  two 
cities,  167;  teachers’  evidence  and,  222; 
records  of  conduct  of  other  members  of 
family  in,  265 

Probationers:  work  for,  hampered  by  con¬ 
dition  of  court  records,  265 

Prognoses,  Medical:  conflicting,  illustrated, 
206;  importance  of  asking  for,  213 

Promises,  Premature:  in  first  interview 
129, 130 

Proof:  defined,  55 

Property:  a  matter  of  public  record,  123 

Property  Records:  consultation  of,  in  three 
cities,  255;  as  revealing  whereabouts, 
260;  uses  of,  262-264 

Psychiatrist,  A  Distinguished:  quoted  re¬ 
garding  questionnaire  on  a  child  possibly 
feeble-minded,  228 

Psychiatrists:  Dr.  Adolf  Meyer’s  instruc¬ 
tions  to,  applied  to  method  of  conducting 
first  interview,  115 

Psychic  Treatment  of  Nervous  Disorders:  by 
Paul  Dubois,  M.D.,  116,  136,  347 

Psychological  Clinic  of  University  of  Penn¬ 
sylvania,  34 

Psychologists:  can  throw  direct  light  on 
social  worker’s  problems,  62;  inquiry 
into  witnesses’  powers,  etc.,  must  come 
from,  66 


504 


INDEX 


Psychology:  in  psychological  clinic  and  psy¬ 
chopathic  institute,  34;  need  that  case 
workers  should  know  more  about,  49; 
social  diagnosis  as  an  adjunct  to,  358; 
two  concepts  of,  that  underlie  social  case 
work,  367-370 

Psychoneurotic  Patient:  analysis  of  initial 
interviews  with  a,  457-461 

Psychopathic  Institute  of  Chicago  Juvenile 
Court,  34 

Public  Departments:  character  of  investi¬ 
gations  in  some,  302 

Public  Officials  as  sources  of  information, 
285-288 

Public  Organization  of  the  Labor  Market,  Part 
II  of  the  Minority  Report  of  the  English 
Poor  Law  Commission,  237 

Putnam,  James  Jackson,  M.D.,  4,  26,  136 


Questionnaires:  place  of,  in  this  study,  8, 
9;  objects  and  dangers  of,  373-374;  use 
of,  illustrated,  374~375;  regarding  any 
family,  378-381 ;  regarding  an  immigrant 
family,  387-394;  regarding  a  deserted 
family,  395-400 ;  regarding  a  widow  with 
children,  400-404;  regarding  a  neglected 
child,  405-412;  regarding  an  unmarried 
mother,  414-419;  regarding  a  blind  per¬ 
son,  421-424;  regarding  a  homeless  man, 
425-428;  regarding  an  inebriate,  430- 
433;  regarding  a  patient  possibly  insane, 
436-441;  regarding  a  child  possibly 
feeble-minded,  441-448;  for  supervision 
and  review,  449-453 


Racial  or  National  Bias  of  witnesses,  73-75 

Real  Evidence:  defined,  56,  57 

Reasoning:  from  particular  cases  to  general 
rule,  81;  from  general  rule  to  new  fact 
about  particular  case,  82,  83;  risks  in¬ 
volved  in,  87-93;  sound,  fundamental  to 
social  diagnosis,  99;  processes  of,  illus¬ 
trated  in  two  first  interviews,  120,  12 1; 
place  of,  in  early  stages  leading  to  diag¬ 
nosis,  178 

Reconstruction:  importance  of  noting 

assets  for,  157 

Records,  Medical:  faults  of,  207;  non¬ 
medical  information  contained  in,  219 

Records,  Public:  ages  and  property  in,  123; 
as  sources  of  information  in  three  cities, 
167;  consultation  of,  in  three  cities,  255; 
indicating  whereabouts,  kinds  and  uses, 
260-262;  keeping  of,  in  different  places, 
269;  method  of  consulting,  269-271; 
photographic  copies  of,  in  New  York,  270. 
See  also  Marriage  Records,  Birth  Records, 
etc. 

Records,  Social  Case:  study  of,  made  for 
this  volume,  7;  edited  for  teaching,  7; 
careless  handling  of  facts  in  some,  54; 
defects  in,  pointed  out  by  a  law  school 
graduate,  59;  J.  M.  Vincent  quoted  on, 
68;  uses  of  face  card  of,  in  drawing  in¬ 
ferences,  83,  85;  instruction  to  enter 
“nothing  but  the  facts”  on,  94;  proc¬ 
esses  by  which  diagnosis  arrived  at  not 
revealed  in,  348;  reasons  why  they  can¬ 
not  be  reproduced,  352 


Recreation:  queries  regarding,  for  any 
family,  381;  in  native  country  of  immi¬ 
grant  groups,  383;  for  a  deserted  family, 
399;  for  the  blind,  424;  for  a  child  pos¬ 
sibly  feeble-minded,  446 

Recreation  Movement:  influence  upon  case 
work  of,  32 

Recurrence,  Notation  of:  a  duty  of  case 
worker  and  supervisor,  352 

References:  definition  and  history  of  term, 
52;  investigating  of,  by  one  unfamiliar 
with  problem,  176-178;  worthlessness  of , 

254 

Reform  School  :  consultations  with  relatives 
by  a,  180 

Reforms,  Social:  and  social  case  work,  in¬ 
terdependence  of,  25,  32,  365;  in  which 
teachers  are  interested,  231;  that  have 
been  outgrowths  of  case  work,  365 

Registered  Letters:  uses  of,  336 

Registration  Bureaus:  beginnings  of,  294. 
See  also  Confidential  Exchange 

Rehabilitation  Agencies,  Family.  See 
Family  Agencies 

Relatives:  not  necessarily  competent  wit¬ 
nesses  regarding  a  client,  65 ;  bias  of  self¬ 
esteem  as  affecting  testimony  of,  78;  for¬ 
mal  questions  as  to,  likely  to  bring  untrue 
answers,  123,  124;  use  of  term  in  this 
book  defined,  124,  180;  illustration  of 
client’s  error  in  thinking  consultation 
with,  useless,  124;  importance  of  securing 
clues  as  to,  in  first  interview,  125;  who 
are  members  of  family  group,  influence  of, 
156,  157;  as  sources  of  information  in 
three  cities,  167;  principle  that  should 
govern  consultation  of,  170-17  2;  on  two 
sides  of  family,  need  of  seeing,  175;  num¬ 
bers  consulted  by  different  types  of  agen¬ 
cies,  180;  objections  of  clients  to  having 
social  worker  see,  180,  186;  prejudice  and 
partisanship  of,  181-183;  failure  of,  to 
know  and  understand,  183-186;  discrimi¬ 
nation  needed  in  choice  of  which  ones  to 
see,  185;  tendency  to  turn  children  over 
to  care  of,  185-186;  as  sources  of  indi¬ 
vidual  and  family  history,  186-187;  as 
sources  of  insight,  188;  backing  and  co¬ 
operation  from,  189-194;  right  of,  to  be 
considered,  194;  questions  of  support 
from,  195-200;  examples  of  unwise  ap¬ 
proach  to,  198,  199;  enforcement  of  finan¬ 
cial  responsibility  upon,  199;  illustration 
of  concealment  of,  279;  undertaker  as  a 
source  of  information  regarding,  289-290; 
letters  of  inquiry  addressed  to,  322-323; 
essentials  in  letters  of  inquiry  to,  328-329; 
queries  regarding,  for  a  widow’s  family, 
404;  for  a  homeless  man,  428 

Relief:  questions  of,  in  interviews  with  rela¬ 
tives,  198;  prevention  of  overlapping 
of,  and  the  confidential  exchange,  307; 
queries  regarding,  for  any  family,  381; 
for  an  immigrant  family,  392;  for  a  de¬ 
serted  family,  397,  400;  for  a  widow’s 
family,  402;  for  a  neglected  child,  410, 
411,412;  for  a  blind  person,  423-424 

Relief  Departments:  public  and  private, 
included  in  statistical  study  of  outside 
sources,  161;  public  outdoor,  consulta¬ 
tions  with  relatives  by,  180 


505 


INDEX 


Relief  Order,  Public:  inference  regarding 
possibility  of  family’s  living  on,  82 

Relief  Societies:  careless  handling  of  facts 
by  one,  53;  changes  in  policy  as  to  place 
of  first  interview  by,  106;  consultations 
with  relatives  by,  180;  use  of  present 
neighbors  by,  273 

Religion:  in  native  country  of  immigrant 
group,  queries  regarding,  384 

Religious  Affiliations:  queries  regarding, 
for  any  family,  380-381;  for  an  immi¬ 
grant  family,  391;  for  a  deserted  family, 
399;  for  a  widow’s  family,  404;  for  the 
family  of  a  neglected  child,  407;  for  an 
inebriate,  433 

Report  of  the  Inspector  under  the  Inebriates  Act, 
1909:  by  R.  W.  Branthwaite,  429 

Reports  to  Medical  Sources:  useful  in 
strengthening  relations,  218 

Research,  Social:  investigation  and,  52 

Residence:  inference  regarding  constant 
changes  of,  81 ;  legal,  need  of  establishing, 
261 

Residences,  Previous:  obtaining  informa¬ 
tion  regarding,  in  first  interview,  126; 
principle  of  choice  of  those  to  be  visited, 
278,  279 

Resources:  queries  regarding,  for  an  immi¬ 
grant  family,  393;  for  a  widow’s  family, 
404 

“ Responsibility  of  Family  Life:”  by  Annie  L. 
Chesley,  192 

Restatement  of  certain  aspects  of  earlier 
processes  in  social  diagnosis,  342-347 

Retardation  in  School:  inference  as  to,  89 

Richmond,  M.  E.,  147 

Risks:  involved  in  thinking,  87^-93;  arising 
from  the  thinker’s  state  of  mind,  94 

Rooms:  number  of,  occupied,  inference  from, 
81,  86;  extra,  inference  from  family’s 
not  renting,  83,  85,  86;  dark,  duty  of 
social  worker  regarding,  151 

Rule,  Mistaken  General:  as  source  of 
error  in  reasoning,  87,  88-90 

Rules  that  save  trouble  of  thinking,  17 1 

Rumors:  regarding  property  too  often  ac¬ 
cepted,  252;  unfavorable,  visits  to  former 
residences  may  disprove,  279 

Russell  Sage  Foundation:  this  study  made 
since  author  became  a  member  of  staff  of, 
6;  associates  of  author  in,  10 

Russians:  antipathy  of  Poles  for,  75 

Ruthenians:  attitude  of,  toward  Poles,  75 


St.  Louis:  investigation  of  foundlings  in,  163 

Sailors:  evidence  contained  in  discharge 
papers  of,  249 

Salmon,  Lucy,  9 

Salmon,  Thomas  W.,  M.D.,  435 

Saloon  Keeper:  as  a  witness,  282 

Sanitation:  inference  as  to  relation  between 
part  of  house  occupied  and,  89 
Sayles,  Mary  B.,  10 


Schedule  Used  in  Study  of  Outside 
Sources:  result  of  early  experiment 
with,  163;  reproduced,  466 

Scholarship:  evidence  of  teachers  regarding, 
224 

School  Census  Records:  use  of,  reported 
by  a  child  labor  committee,  262 

School  Efficiency:  by  Paul  H.  Hanus,  368 

School  Evidence:  in  cases  studied,  221; 
place  of,  in  social  work,  222;  as  to  grade, 
223;  as  to  scholarship,  224;  as  to  atten¬ 
dance,  225;  as  to  behavior,  226;  as  to 
physical  condition,  227;  as  to  mental 
condition,  227-229;  as  to  home  care,  229; 
as  to  results  of  social  treatment,  230-231; 
defects  of,  231-232;  method  in  gathering, 
232-233 

School  History  Record  Cards:  informa¬ 
tion  called  for  on,  223 

School  Records:  as  evidence  of  age,  257- 
258 

Schooling:  queries  regarding,  for  any  family, 
380.  See  also  Education 

Schools:  advantages  and  disadvantages  of 
social  work  connected  with,  105,  106; 
information  regarding,  easily  obtained  in 
first  interview,  126;  as  sources  of  infor¬ 
mation  in  three  cities,  167;  as  one¬ 
headed  sources,  175;  individual  and  mass 
treatment  in,  368 

Science,  Natural:  methods  of,  contrasted 
with  those  of  social  case  work,  40,  43; 
observers  in,  contrasted  with  witnesses, 

52 

Scientific  Shop  Management:  need  of 
social  technique  in,  48 

Scope:  of  first  interview,  111-114;  of  a  work 
record,  239 

Seamen.  See  Sailors 

Sears,  Amelia,  81,  88,  155,  241,  249,  274, 
276,  282 

Seignobos,  Charles,  49,  64,  68,  69 

Self-discipline:  in  training  memory,  im¬ 
portant  to  case  worker,  127 

Self-esteem:  collective,  a  form  of  self-inter¬ 
ested  bias,  77,  78;  social  workers’  lia¬ 
bility  to  bias  of,  79 

Self-help:  importance  of  beginning  to  de¬ 
velop,  in  first  interview,  114 

Self-interest:  bias  due  to,  as  affecting 
testimonial  evidence,  76-78 

Self-supervision:  suggestions  for,  349-351 

Self,  The  Wider:  concept  of,  underlies 
social  work,  368-370 

Sermons,  Biographical  and  Miscellaneous,  by 
Benjamin  Jowett,  138 

Settlement  Laws:  as  complicating  factors 
in  social  work,  261 

Settlements,  Social:  considered  in  this 
book  among  social  agencies,  282;  type 
of  evidence  supplied  by,  299-300;  train¬ 
ing  of  worker  in,  compared  with  that  of 
C.  O.  S.  worker,  300;  objections  of,  to 
use  of  confidential  exchange,  307;  advice 
of  leaders  in,  value  to  social  worker  study¬ 
ing  foreign  groups,  386;  service  of,  in 
interpreting  immigrant  life  to  public,  386 


506 


INDEX 


Sewing  Machine  Company:  used  as  a  clue 
in  discovering  whereabouts,  289 

Sex  Life:  of  a  person  possibly  insane,  438. 
See  also  Morality 

Sheffield,  Mrs.  Ada  Eliot,  9,  182,  413,  414 

Sheriffs:  consultations  with,  by  social 
agencies,  287 

Shifting  Family:  inference  regarding,  81,  90 

“Shop:”  knowledge  of,  as  to  home  condi¬ 
tions,  241 

Sidgwick,  Alfred,  49,  87,  97 

Simkhovitch,  Mrs.,  196,  197 

Sisters:  legal  responsibility  of,  for  support 
in  different  states,  19s 

Slavic  Nationalities:  racial  bias  among,  75 

Smith,  Zilpha  D.,  72,  197,  270,  308,  310 

Social  Adjustment:  queries  regarding,  for 
an  immigrant  family,  390-392 

Social  Agencies:  that  trust  intuitions,  as 
witnesses,  66;  types  of,  included  in  sta¬ 
tistical  study  of  outside  sources,  16  x;  as 
sources  of  information  in  three  cities,  167 ; 
records  of,  as  evidence  of  age,  257;  con¬ 
sultations  with,  in  2,800  cases  examined, 
296-297,  298;  as  witnesses,  of  their  own 
experience,  297-301;  as  witnesses,  of 
data  that  they  have  gathered,  301-303; 
changes  of  management  in,  302;  influ¬ 
ence  upon,  of  a  confidential  exchange, 
304-305;  in  Boston,  use  made  of  confi¬ 
dential  exchange  data  by,  308-3 10 ;  trans¬ 
fers  and  co-operation  among,  3 13-3 14; 
conferences  of  representatives  of,  about 
difficult  cases,  315;  indirect  communi¬ 
cations  between,  unwise,  315;  letters  of 
inquiry  to,  333;  queries  regarding  rela¬ 
tions  with,  for  any  family,  381;  for  a 
deserted  family,  397,  400;  fora  widow’s 
family,  402;  for  family  of  a  neglected 
child,  410-41 1,  412 

Social  and  Ethical  Interpretations  in  Mental 
Development:  by  James  Mark  Baldwin, 

369 

Social  Case  Work:  methods  and  aims  should 
be  same  in  all  types  of,  5 ;  beginning  proc¬ 
esses  of,  alone  discussed  here,  6,  26; 
and  social  reform  progress  together,  25, 
365;  uses  of,  in  other  fields,  27;  develop¬ 
ment  of  technique  in,  32;  dangers  to, 
when  an  adjunct  in  clinic  or  court,  36; 
danger  that  beginners  in,-  will  become 
hypercritical,  79;  drawing  inferences 
from  a  face  card  good  drill  for  a  beginner 
in,  83;  extreme  subdivision  of,  106;  as 
team  work,  114;  sources  consulted  in 
different  types  of,  167-169;  four  stages  in 
development  of,  in  U.  S.,  293 ;  third  stage 
of  co-operation  in,  294-295 ;  highest  form 
of  co-operation  in,  295-296;  ways  of  ad¬ 
vancing  standards  in,  362-363;  part  of, 
in  work  for  the  inebriate,  425,  429-430. 
See  also  Social  Workers 

Social  Conditions:  queries  regarding,  in 
case  of  an  inebriate,  432 

Social  Data:  and  medical  data,  207-21 1; 
queries  regarding,  for  any  family,  378- 
379 

Social  Instincts:  of  a  person  possibly  in¬ 
sane,  438-439 


Social  Relationships:  of  a  child  possibly 
feeble-minded,  445 

Social  Service  Exchange.  See  Confidential 
Exchange  and  Social  Service  Exchange, 
New  York 

Social  Service  Exchange,  New  York: 
variable  spellings  in,  270;  specimen  list 
of  variable  spellings  in,  472-479 

Social  Status  :  of  parents  of  a  patient  possi¬ 
bly  insane,  436 

Social  Treatment:  school  evidence  regard¬ 
ing,  230-231 

Social  Workers:  invited  to  send  criticisms  of 
this  volume  to  the  author,  xx;  in  U.  S., 
a  large  group,  25;  desire  of  physician  to 
engage  one,  for  service  to  a  private  pa¬ 
tient,  27;  beginnings  of  training  for,  31, 
32;  and  court,  difference  in  point  of  view 
between,  42,  43;  need  of  diagnostic  skill 
in  dealing  with  courts,  illustrated,  45; 
attitude  of,  toward  hearsay  evidence,  57; 
tendency  on  part  of  some,  to  accept  un¬ 
favorable  testimony  too  readily,  59;  char¬ 
acter  evidence  as  used  by,  61,  62;  should 
understand  tests  of  a  witness’s  bias  and 
competence,  64,  65;  will  have  to  apply 
elements  of  psychology  in  social  work,  66; 
funded  thought  of,  67-68;  suggestibility 
of  clients  as  affecting  work  of,  70;  dan¬ 
gers  of  leading  questions  to  be  guarded 
against  by,  71;  should  shun  small  sub¬ 
terfuges,  72;  racial  or  national  bias  as 
affecting  work  of,  73-75 ;  cannot  ask  wit¬ 
nesses  to  violate  their  own  standard  of 
ethics,  76;  liability  of,  to  bias  of  self¬ 
esteem,  79;  use  of  hypothesis  by,  85; 
risks  arising  from  predispositions  of,  94; 
formerly  instructed  to  enter  “nothing  but 
the  facts”  on  records,  94;  risks  arising 
from  assumptions  of,  95;  habit  of  con¬ 
sulting  same  few  sources  hampers  some, 
96 ;  absorption  in  individual  case  and  op¬ 
pression  by  condition  of  mass  among,  97 ; 
warning  to,  about  use  of  method  of  proba¬ 
bilities,  97;  risk  that  personal  prejudices, 
etc.,  may  influence  judgment  of,  97,  98; 
desire  of,  for  prompt  action,  responsible 
for  invalid  inference,  98,  illustrated,  350; 
skill  of,  as  shown  in  first  interview,  104; 
method  of,  in  first  interview,  as  modified 
by  nature  of  task,  105;  method  of,  as 
modified  by  place  of  first  interview,  106- 
no;  method  of,  as  modified  by  origin  of 
application,  106;  mental  equipment  and 
philosophy  of,  as  affecting  first  interview, 
111;  one  of  long  experience  quoted  on 
method  in  first  interview,  1 1 2-1 13 ;  asked 
to  write  analyses  of  first  interviews,  120; 
two  types  of  interviewers  among,  121, 
1 22-1 23;  one  quoted  on  misuse  of  face 
card,  122;  should  train  memory',  127; 
convictions  of,  about  family,  influence 
and  are  influenced  by  his  work,  134;  acts 
of,  may  influence  members  of  family  he 
has  not  seen,  134;  should  take  family 
history  and  home  conditions  into  account, 
134-137;  welcome  chance  to  see  family 
together  at  beginning,  137;  should  seek 
to  grasp  main  drift  of  family  life,  139; 
suggestions  as  to  study  of  food  habits  of 
family  by,  148-150;  housing  defects  that 
should  arrest  attention  of,  15 1;  habit 
of  some,  of  dealing  with  families  only 
through  children,  153;  not  overinvest' 


507 


INDEX 


Social  Workers  ( continued ) 

gating,  163;  tendency  of,  to  dwell  on 
present  situation  of  clients,  169;  seven 
principles  that  should  govern  choice  of 
clues  to  be  followed  up  by,  170-176; 
principles  that  should  govern,  in  dealing 
with  medical  data,  187;  responsibility  of, 
for  obtaining  early  medical  diagnosis,  211, 
should  never  attempt  to  make  a  medical 
diagnosis,  211,  216;  medical  literature  for, 
212;  need  of  economy  of  medical  re¬ 
sources  on  part  of,  2 13-2 14;  etiquette  of 
relations  of,  to  incompetent  physicians, 
214;  can  sometimes  obtain  fuller  reports 
from  physicians  through  physicians,  217; 
school  sources  imperfectly  used  as  yet  by, 
221 ;  help  that  may  be  given  teachers  by, 
233;  employed  by  industrial  establish¬ 
ments,  approach  should  be  made  through, 
247 ;  warned  to  distrust  their  own  knowl¬ 
edge  in  accident  cases,  247-248;  substi¬ 
tution  of  a  developing  for  a  static  pro¬ 
gram  by,  in  dealing  with  employers,  251; 
can  seek  source  behind  document,  254; 
interest  of,  in  securing  better  public 
records,  255;  too  likely  to  accept  hear¬ 
say  evidence  regarding  property,  262; 
acquaintance  with  public  records  needed 
by,  271;  importance  of  relations  to  client 
and  to  other  agencies,  compared,  294; 
duplicate  letters  of  inquiry  by,  326;  les¬ 
sons  drawn  from  Dr.  Cabot  and  Dubois 
for,  347-348;  Index  Expurgatorius  of, 
349;  two  kinds  of  equipment  needed  by, 
376;  knowledge  of  local  laws  and  ordi¬ 
nances  regarding  deserters  assumed  in, 
295;  Dr.  Adolf  Meyer’s  advice  to,  quoted, 
434-435;  a  supervision  and  review  ques¬ 
tionnaire  for,  449-453 

Society:  discussion  of  theories  of,  no  part  of 
plan  of  this  book,  134 

Society  to  Protect  Children  from 
Cruelty:  worker  who  went  from  a 
charity  organization  society  to,  quoted, 
39;  method  of  agent  of,  in  conducting 
first  interviews,  104,  129;  opinion  of  gen¬ 
eral  secretary  of,  as  to  place  of  first  inter¬ 
view,  108;  account  of  first  interview  by 
worker  in,  117;  emergency  interview  re¬ 
ported  by  agent  of,  132;  interviewing  of 
husband  and  wife  by  worker  for,  143; 
included  in  statistical  study  of  outside 
sources,  161;  distinction  of  supplemen¬ 
tary  clue  in  work  of,  175;  consultations 
with  relatives  by,  180;  experience  of, 
with  relatives,  illustrated,  183,  184;  case 
of  children  improperly  placed  with  grand¬ 
parents  cited  by,  186;  story  of  reuniting 
of  brothers  placed  out  from  a  foundling 
asylum  supplied  by,  195;  approach  to 
relatives  in  a  difficult  case  by  agent  of, 
201;  instance  of  non-social  attitude  on 
part  of  a  physician  reported  by,  205 ;  ex¬ 
perience  of,  with  conflicting  medical  diag¬ 
noses  and  prognoses,  206;  illustration  of 
mistaken  diagnosis  by,  corrected  by  evi¬ 
dence  from  medical  field,  208;  habitual 
consultation  with  school  sources  by,  222; 
fellow  pupils  consulted  in  a  few  tasks  of, 
233 ;  instances  of  valuable  employer  tes¬ 
timony  reported  by,  243;  case  of  father 
who  left  children  alone  reported  by,  24  - 
245;  cases  where  consultation  of  birth 
records  necessary,  reported  by,  256;  use 
voting  list  and  enlistment  records  in 


locating  men  reported  by,  260;  use  of 
present  neighbors  by,  273,  274,  276,  277; 
unfounded  complaint  from  a  landlord  re¬ 
ceived  by,  281;  suggestion  as  to  dealings 
with  police  offered  by  worker  in,  286; 
case  reader’s  notes  on  effects  of  a  change 
of  management  in,  302;  court  work  ren¬ 
dered  unnecessary  by  other  measures  in, 
314;  letter  to  a  father  by,  332;  letters 
shown  by  clients  copied  by,  335;  use  of 
telephone  in  rural  districts  reported  by, 
339 

Solenberger,  Mrs.  Alice  W.,  73,  425 

“ Some  Conditions  Affecting  Problems  of  In¬ 
dustrial  Education  in  Seventy-eight  Ameri¬ 
can  School  Systems:”  by  Leonard  P. 
Ayres,  202 

Sources  of  Information:  habit  of  consult¬ 
ing  same  few,  96 

Sources  of  Information  Outside  Family 
Group:  reasons  for  consulting,  160;  sta¬ 
tistics  of,  how  gathered,  161,  162;  average 
number  consulted,  means  little,  163; 
twenty  most  used  in  three  cities,  165; 
order  of  consultation  in  three  cities,  166; 
most  used  in  different  types  of  social 
work,  167-169;  principles  governing  use 
of,  169-176;  groups  of,  one-headed  and 
other,  175;  method  in  visiting,  176-178; 
importance  of  discovery  of  new,  284;  pro¬ 
portion  of  out-of-town,  among  those  con¬ 
sulted  in  2,800  cases,  321;  in  consulting 
which,  inquiry  can  safely  be  narrowed, 
343-344;  discrimination  in  choice  of,  344- 
346;  queries  regarding  case  worker’s  use 
of,  450-451;  form  used  in  gathering  sta¬ 
tistics  regarding,  466;  table  giving  in  full, 
for  three  cities,  467-469;  table  giving  by 
agencies,  for  one  city,  470-471 

Special  Delivery  Letters:  and  registered 
letters,  336 

Specialist:  overemphasis  of  the,  need  of 
guarding  against,  96 

Specialization  Among  Social  Agencies  : 
necessitates  exchange  of  information,  303 

Spellings,  Variable:  each  community 
should  work  out  its  own  list  of,  270;  con¬ 
fusion  caused  by,  illustrated,  271;  list  of 
specimen,  recorded  in  a  social  service 
exchange,  472-479 

Sporting  Editor:  consultation  with,  re¬ 
ported  by  a  medical-social  department, 
290 

Standard  of  Life:  by  Helen  Bosanquet,  368 

Standard  of  Living:  by  R.  C.  Chapin,  128 

Standards  in  Social  Case  Work:  attempts 
to  establish,  25,  30;  ways  of  advancing, 
362-363 

State  Archives:  in  which  birth  records  are 
assembled,  256 

State  Board  of  Charity:  letter  of  inquiry 
by  a,  cited,  330 

Statistical  Study:  made  for  this  volume,  8 

Statistics  of  Outside  Sources:  how  gath¬ 
ered,  161,  162;  form  used  in  gathering, 
466 

Store  Inspectors,  City:  consultations  with, 
by  social  agencies,  287 

508 


INDEX 


“Stream  Pictures”:  as  evidence  of  feeble¬ 
mindedness,  43 

Street  Guides:  use  of,  before  sending  out- 
of-town  letters  of  inquiry,  333 

Street  Inspectors,  City:  consultations 
with,  by  social  agencies,  287 

Street's  Pandex  of  the  News,  269 

Suggestibility:  as  affecting  the  competence 
of  witnesses,  69-71 

Suggestions  for  Systematic  Inquiry:  by  C.  J. 
Ribton-Turner,  31 

Suicide:  queries  regarding,  as  to  parents  of  a 
patient  possibly  insane,  437;  as  to  the 
patient  himself,  440 

Summaries:  case,  as  an  aid  in  securing  medi¬ 
cal  co-operation,  218;  written,  use  of,  by 
some  case  workers,  340;  to  case  com¬ 
mittees,  uses  of,  348 

Summary  :  of  certain  aspects  of  earlier  proc¬ 
esses  in  social  diagnosis,  342-347 

Summary,  Diagnostic:  content  of,  360;  of 
the  Ames  case,  361 

Summary  of  State  Laws  Relating  to  the  Depen¬ 
dent  Classes,  195 

Sunday  School  Teachers  :  utilization  of  ex¬ 
perience  of,  233 

Supervision  and  Review  Questionnaire, 
449-453 

Supervision,  Self-:  suggestions  for,  349- 
35i 

Supervisor,  Case:  value  of  submitting  find¬ 
ings  to,  348;  suggestions  for  comparisons 
made  by  a,  351-352 

Supervisors,  Chairmen  of  Board  of:  con¬ 
sultations  with,  by  social  agencies,  287 

Support:  responsibility  of  relatives  for,  195- 
200 

Synge,  John,  185 


Tea,  Overuse  of:  Dr.  Healy’s  findings  re¬ 
garding,  150 

Teachers:  information  regarding,  easily  ob¬ 
tained  in  first  interview,  126;  habit  of 
some  of  dealing  with  families  through 
children,  153;  differences  in  use  of,  in 
three  cities,  167;  testimony  of,  to  S.  P. 
C.  C.  and  probation  officers,  222;  evi¬ 
dence  of,  on  grade,  223-224;  evidence  of, 
on  scholarship,  224;  evidence  of,  regard¬ 
ing  attendance  and  behavior,  225-226; 
evidence  of,  regarding  physical  condition, 
227;  evidence  of,  regarding  mental  con¬ 
dition,  227-229;  evidence  of,  regarding 
home  care,  229-230;  evidence  of,  regard¬ 
ing  results  of  social  treatment,  230-231; 
questions  that  need  not  be  asked  of,  23 1 ; 
interest  of,  in  certain  reforms,  231;  de¬ 
fects  in  evidence  of,  231-232;  reports  to, 
by  social  workers,  233 

Team  Sense:  in  social  work,  292 

Technique:  in  social  case  work,  49 

Telegraph:  communication  by,  336-337 

Telegraphic  Code:  used  by  social  agencies 
in  U.  S.,  337 


Telephone:  communication  by,  uses  and 
dangers  of,  247,  337~340 

Temperament:  queries  regarding,  for  a  pa¬ 
tient  possibly  insane,  438-439;  for  a 
child  possibly  feeble-minded,  44s 

Testimonial  Evidence:  probative  value  of, 
55;  distinguished  from  other  types  of 
evidence,  56,  57;  direct  and  indirect,  il¬ 
lustrated,  59;  an  historian’s  tests  of  good 
faith  and  accuracy  as  affecting,  64;  com¬ 
petence  of  witness  in,  65-73;  attention  of 
witness  as  affecting  value  of,  66-68; 
memory  of  witness  as  affecting  value  of, 
68-69;  suggestibility  of  witness  as  affect¬ 
ing  value  of,  69-70;  leading  questions  as 
affecting  value  of,  7i~73;  racial  or  na¬ 
tional  bias  of  witness  as  affecting  value 
of,  73-75;  environmental  bias  as  affect¬ 
ing  value  of,  75-76;  bias  of  self-interest 
as  affecting  value  of,  76-78 

Testimonials  proffered  by  clients,  254 

Testimony:  given  against  self-interest,  value 
of,  76;  personal,  when  most,  and  when 
least,  satisfactory,  254;  social  agency, 
two  functions  of,  296-303 

Tests,  Mental:  need  of  repetition  of,  47 

Thayer,  James  B.,  49,  53,  56,  269 

Thayer,  William  Roscoe,  385 

Theories  of  Social  Worker  and  his  work, 
mutual  influence  of,  134 

Theory:  value  of  evidence  gathered  to  cor¬ 
roborate  or  disprove  a,  87 

Therapy,  Social  and  Medical:  relations  of, 
to  social  reform  and  to  medical  science, 

367 

Thinking.  See  Reasoning 

Thorndike,  E.  L.,  367,  369 

Time  Element:  in  diagnosis,  361-363 

Toilet  Arrangements:  defects  in,  which 
social  workers  should  look  for,  15 1 

Town  Clerk:  as  a  source  of  information,  287 

Trade  Unions:  inference  from  membership 
in,  81,  86;  as  one-headed  sources,  175; 
instances  of  co-operation  on  part  of,  250 

Tradesmen:  former  local,  use  of,  in  three 
cities,  273;  present  local,  use  of,  in  three 
cities,  273 

Transfer:  to  another  agency,  and  the  prob¬ 
lem  of  co-operation,  313,  314 

Transition  Period  in  Widowhood:  queries 
regarding,  402 

Translators:  choice  of,  for  documents  in  a 
foreign  language,  271 

Transportation  Agreement:  among  social 
agencies  in  U.  S.,  337 

Travel,  Books  of:  as  aid  to  study  of  native 
country  of  immigrant  groups,  386 

Treasurer,  City:  consultations  with,  by 
social  agencies,  287 

Treatise  on  the  Law  of  Evidence:  by  Simon 
Greenleaf,  72 

Treatise  on  the  System  of  Evidence  in  Trial 
at  Common  Law:  by  J.  H.  Wigmore, 


509 


INDEX 


Treatment,  Social:  wider  usefulness  of,  6; 
importance  of  case  workers’  conception 
of  possibilities  of,  n;  confidential  ex¬ 
change  improves,  304;  lack  of  connection 
between  plan  of,  and  investigation,  348; 
need  of,  in  administrative  tasks,  365;  a 
few  questions  on,  included  in  question¬ 
naires,  378;  queries  regarding,  basis  for, 
in  any  family,  381 ;  in  case  of  an  inebriate, 
432 

Tuberculosis:  need  of  noting,  in  family  his¬ 
tory,  187;  possibility  of  diagnosing  as 
unemployment  due  to  laziness,  358 

Turner,  C.  J.  Ribton-,  31 


Understanding,  A  Good:  one  of  objects  of 
first  interview,  112,  113,  114 

Undertaker:  as  a  source  of  information 
regarding  relatives,  290 

Unemployment:  different  types  of,  236-237 

Union.  See  Trade  Union 

United  States:  social  workers  in,  a  large 
occupational  group,  25;  Octavia  Hill’s 
influence  in,  30;  children’s  courts  in,  44; 
frequent  migrations  within,  as  affect¬ 
ing  consultations  with  relatives,  202 

United  States  Bureau  of  Labor  Report  on  Con¬ 
ditions  of  Employment  in  the  Iron  and 
Steel  Industry,  237 

United  States  Bureau  of  Labor  Report  on  Con¬ 
dition  of  Women  and  Child  Wage-earners, 
237 

Unmarried  Mother,  Questionnaire  Re¬ 
garding  an,  413-419.  See  also  Mother, 
U  nmarried 

Uses  of  a  Work  Record,  236-238 


Van  Kleeck,  Mary,  25,  237 

Verification:  not  the  aim  of  inquiry  into  a 
work  record,  236 

Vicar  of  Wakefield,  153 

Vincent,  J.  M.,  68 

Vision:  in  a  blind  person,  queries  regarding, 
421-422 

Visiting  Nurse  Association:  and  C.  O.  S., 
division  of  territory  between,  296 

Visiting  Teachers.  See  Home  and  School 
Visitors 

Vocational  Guidance:  need  of  social  evi¬ 
dence  in,  illustrated,  46-48 

Volunteer  Visiting:  in  Boston,  influence  of 
Octavia  Hill  on,  30 

Voting  Lists  as  records  of  whereabouts,  260 

“Vouching”  in  early  English  law  courts,  52 


Wages:  unstandardized,  as  affecting  indi¬ 
vidual  case  treatment,  237.  See  also 
Earnings 

War  Department:  consultations  with,  by 
■  social  agencies,  288 

■^ssermann  Reaction:  Dr.  Lewellys  F. 
■^wker  quoted  regarding,  366 


Water  Supply,  Insufficient:  points  re¬ 
garding,  that  social  workers  should  note, 

151 

“  What  Do  Histories  of  Insanity  Teach  Us 
Concerning  Preventive  Mental  Hygiene 
During  the  Years  of  School  Life?”  by 
Adolf  Meyer,  M.D.,  114 

Whereabouts:  records  indicating,  kinds  and 
uses  of,  260-262;  registered  letters  used 
to  establish,  336 

Whipple,  Guy  M.,  68,  69,  70 

Wider  Self:  concept  of,  at  the  base  of  social 
case  work,  368-370 

Widow  with  Children:  instance  of  unre¬ 
liable  evidence  from  an  employer  regard¬ 
ing,  241;  undesirable  relatives  in  home 
of,  156;  account  of  investigation  of,  il¬ 
lustrating  principles  governing  choice 
of  sources,  171-172;  questionnaire  re¬ 
garding  a,  400-404 

Widowhood:  formerly  confused  with  deser¬ 
tion,  358-359,  395 

Widows  with  Children  Records:  school 
evidence  in,  229-230 

Wife:  and  husband,  common  causes  of  trou¬ 
ble  between,  140;  and  husband,  mischief¬ 
making  by  relatives  between,  illustrated, 
182;  points  to  be  remembered  regard¬ 
ing,  in  study  of  family  group,  147-148; 
queries  regarding  early  life  of,  for  deser¬ 
tion  cases,  398 

WiGMORE,  J.  H.,  9,  49,  56,  57,  68,  69,  70,  305 

Williams,  Frankwood  E.,  M.D.,  69 

WlTMER,  LlGHTNER,  34 

Witnesses:  tests  of  bias  and  competence  of, 
64,  65 ;  attention  as  affecting  competence 
of,  66-68;  memory  as  affecting  compe¬ 
tence  of,  68-69;  suggestibility  of,  69-71; 
leading  questions  as  affecting  competence 
of,  71-73;  bias  of,  different  kinds,  73-79; 
social  diagnostician’s  ability  in  dealing 
with,  as  part  of  his  equipment,  98;  who 
have  made  first-hand  observations  to  be 
preferred,  172-174;  court,  difficulty  in 
persuading  present  neighbors  to  become, 
277;  evaluation  of  personality  of,  278; 
social  agencies  as,  in  supplying  data  from 
their  own  experience,  297-301;  social 
agencies  as,  in  supplying  results  of  their 
inquiries,  301-303;  illiterate,  direct  re¬ 
plies  from,  in  answer  to  letters  of  in¬ 
quiry,  324;  characteristics  of,  restated, 
346-347 

Woman’s  Position:  in  native  country  of  im¬ 
migrant  groups,  queries  regarding,  384 

Woods,  Police  Commissioner,  285 

Woods,  Robert  A.,  299,  386 

Woodyard,  Charity:  as  a  work  test  for  an 
Italian  laborer,  86,  87;  unreliability  of, 
in  testing  willingness  to  work,  88 

Work  History.  See  Industrial  History 

Work  Place:  unwisdom  of  trying  to  see 
man  at,  144 

Work  Problems:  of  a  widow’s  family, 
queries  regarding,  403 

Work  Record:  inference  regarding,  drawn 
from  man’s  unwillingness  to  have  em¬ 
ployer  consulted,  88;  uses  of  a,  236-238; 
scope  of  a,  239 


510 


INDEX 


Work  Sources:  miscellaneous,  250-251 

Workhouse  Test:  as  a  substitute  for  inves¬ 
tigation,  28 

Working  Papers:  requirements  regarding, 

225 

Workingmen:  inference  regarding,  drawn 
from  fact  of  membership  in  union,  81,  86- 
reluctance  of,  to  yield  to  sickness,  85  ■ 
inference  regarding  unwillingness  of,  to 
have  employers  consulted,  88;  interests 
of,  to  be  kept  in  mind  in  interviews  with 
employers,  237,  238;  consultation  of 
property  records  in  interest  of,  264.  See 
also  Workmen,  Fellow,  and  Workmen 
Foreign 


Workmen,  Fellow:  better  witnesses  than  his 
family,  to  a  man’s  habits,  123;  value  of 
evidence  of,  242;  co-operation  of,  250-251 

Workmen,  Foreign:  special  points  to  be 
remembered  regarding,  248-249 

Workmen’s  Compensation  Laws:  effect  of, 
upon  social  case  work,  and  vice  versa' 
212,  247-248,  366 

Worthiness  and  Unworthiness:  social 
workers  no  longer  preoccupied  with,  61, 
62  ’ 

Wright,  Lucy,  274,  420,  421 

Year  Books,  State:  as  sources  of  informa¬ 
tion,  266 


51  I 


